HomeMy WebLinkAbout0280 WILLOW STREET 1�
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HASTINGS, MN
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Town of Barnstable *Permit# • 4S�-O
Expi s 6 months from issue date ^
Regulatory Services F
r �
BARNBCABIE, •
MAe&� Thomas F.Geller,Director' o �'� Building Division X-PRESS PERMIT
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601 J U L 0 9 2013 N�
. www.town.bamstable.ma.us
Office: 508-862-4 38 EXPRESS PERMIT APPLICATION - RESIDENTPALM4SANLE
1 I I 05
Not Valid without Red X-Press Imprint
Map/parcel Number 1' ``ti C+
Property Address W AIM) 5 U ns
ETResidential Value of Work$ 3a Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address k-AY1 he. A,M wK\ 4- u K,v�
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable) Email:
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
[r 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) cQA " ���g/es
R`ke-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to V
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
'Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE:
Q:\WPFILES\FORWbuilding permit forms\EXPRESS.doc
Revised 060513
a
The Commonwealth of Massachusetts
Department of Industrial Accidents
O,(jice of Investigations
600 Washington Street
Boston,MA 02111
www.massgovldia
Workers' Compensation.Insurance Affdavitz- Builders/Contractors/]Electricians/Plumbers
Applicant Information Please Print Legibh
Name �: u t",6t./—
Address: S'O LJ 0 l,J � �r<-
City/stat&Zip: 6 a- N-,(AS k-h � 0)66 f� Phone.4-- s G�-
Are you an employer?Check the appropriate box:
I.El am a 1 with 4- ❑ I am a general contractor and I Type of project(required):
r!):
�P s have hired the sub-coatracbo rs
6- ❑New construction
employees(full and/or part-ttme)-
I❑ I am a sole proprietor or partner- listed on the attached sheet_ 7. ❑Remodeling
slip and have no employees These sub-contractors have 8. ❑Demolitim
to and have wormers'
worlring forme in any capacity. � Y� 9. ❑Building addition
[No workers'Comp.insurance Comp.MSuramte.I
required-] 5. ❑ We are a corporation and its ME]Electrical repairs or additions
3. I am a homeowmes doing all weak officers have exercised their I L❑Plumbing repairs or additions
myseI£ [No wormers'oomp. right of es:emption per MGL 12 g Roof repairs
insurance required]f c.152,§1(4�and we have no
employees-[No workers' 13.❑Other
ctmip.insurance required]
•Amy epptix=dmt checks bwz#1—st also fill aat the section below showing dieir wa kere con ipensadon policy udbrmfftim
1 Homeowners who submit this affidavit indicating they ace doing alt wank sod than bi m outside cantractms n',IDSt submit anew affidavit.indicating such_
iContracmrs that check this boa mast attached an additional suet showing the name of the scion and stale whether ornot those entities have
emplMes. If the nub-con=cturs have employers,they unist pmvide their wukers'gyp.po&7 der.
lam an employer that is provi&g workers'compensation inmrance for my.enq)loyeaL Below is the policy aced job situ
information.
Insurance Company Name:
Policy#or Self-ins.Ile.#: Expiration Date:
Job Site Address: City/Stat&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 Q, 152 can lead to the imposition of criminal penalties of a
fine up to S 1,500.00 and/or one-year imprisonmezrt,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 s1a hereby card,&under the ' s and aides afpegipy that the inforatatiAm provided above is true and correct
Date: 7 /
Phone
Dfficial use only. Do not write in this area,to be completad by city or tower v w&1
City or Town: PermitlLuense#
Issuing Authority(circle one):
1.Board of Health 2.Budding Department 3.City/fown Clerk 4.Uectricalluspector S.Plumbing Inspector
6.Other
Contact:Person: Plane#:
�► t 6
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• MRNSTABM •
1639. �,0� Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601 1
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
J. , 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.
C`.\Users\decollik\AppData\Local\Micr6soft\Windows\Temporary Internet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc
Revised 053012
i
I, M
�t Town of Barnstable
Regulatory Services
BMWS ABM ' Thomas F.Geiler,Director
°rE 039. �`0� 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
I
HOMEOWNER LICENSE EXEMPTION
,ATE: // Please Print
)B LOCATION: OWO V t 110t,-1 S 7—
number street village
HOMEOWNER": MUl2�`7" O — 3 ���
6 home phone# work phone#
URRENT MAILING ADDRESS: -
city/town T state zip code
be current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow
omeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
erson(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
-
tmily dwelling,attached•or detached structures accessory to such use and/or farm structures. A person who constructs more than one
ome in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form
:ceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section
09.1.1)
he undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,
ylaws,rules and regulations.
he undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection
poce.dures and r q ' ements at he/she will comply with said procedures and requirements.
gnature of Homeowner
pproval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code
-ction 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
•om the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors); provided that if the homeowner
.igages a persons)for hire.to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the'.responsibilities of a supervisor
ee Appendix.Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often
cults in serious problems, particularly when the homeowner hires unlicensed persons. In this case,.our Board cannot
roceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is
ltimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the
ermit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page
r this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in
)or community.
\Users\decollkWppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc
evised 053012
x /
Assessor's-Office(1st floor) Map Parcel �'7 it# 1 7(O o.
Conservation Office(4th floor)(8:30-9:30/1:00-2:00) 1 q6ate Issue -P - q -9
Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) 0- _ � Fee aw
Engineering Dept. (3rd floor) House# IN
�c�9�, _
Planning Dept.(1st floor/School Admin. Bldg.) SEP71C ��
CZ
Definitiv an, pproved by Planning Board 19
���ARON t CZ�7 r„D
TOWN OF BARNSTABLE
' Building Permit Application
Proje Address .2,90
Village G✓, , /,_
Owner (c�I_ 4, V,*=Z,4 Address
Telephone 6 Z—3 .5"'
Permit Request <o Ll p
Z..4S 6 /2929C S Co 1�90
R /2 'v
First Floor square feet
Second Floor square feet
oG
Estimated Project Cost $ MO
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ?
Zoning Board of Appeals Authorization Recorded
Current Use Proposed Use
Construction Type
Commercial Residential (/
Dwelling Type: Single Family ✓ Two Family Multi-Family
Age of Existing Structure Basement Type: Finished
Historic House Unfinished
Old King's Highway
Number of Baths No. of Bedrooms
Total Room Count(not including baths) First Floor
Heat Type and Fuel Central Air Fireplaces
Garage: Detached Other Detached Structures: Pool
Attached Barn
None Sheds
Other
Builder Information
Name ory! / Z/ Telephone Number
CA Address /Zlz wjo 2Z ef%Zi>AYX License# a:C2,4 9 Z
e05,P19_ ni zz/ /A020, a��v g/&1,n4w7- Home Improvement Contractor# /&4 O7yD
% Worker's Compensation# dA WOWAI 23VR
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
yr�
SIGNATURE DATE o2 9 ��
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY
PERMIT NO.
4
DATE ISSUED
MAP/PARCEL NO. '
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME- "
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL - -
PLUMBING: ROUGH FINAL "
f jff
GAS: ROUGH , FINAL
t
FINAL BUILDING.
DATE CLOSED OUT�`�
ASSOCIATION PLAN NO. -
1 '� i j r ' + Y 1 � •
.'�� • Application to
, �P�•1►'PIP'EP•K•� .. '
Old Kin 's Highway Regional Historic District Committee :
in the Town of Barnstable for a 77 '
CERTIFICATION OF EXEMPTION •;4'rP'f f., t '
Application is hereby made, in triplicate,for the issuance of'a certificate of exemption under Section 6 and 7 of Chapter 470,
Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans,drawings,or photo-
graphs accompanying this application. �_•.^+ v_ ;, :. r'-
TYPE OR PRINT LEGIBLY ;:. `{ - ',DATE - — —.
ADDRESS OF PROPOSED WORK %'ASSESSORS MAP NO.
lA� �'�✓� ssA
,,. OWNER G ASSESSORS•LOT NO. �7
a2 o aLf-4ew ST (/U� � ! TEL NO.36Z" 2 S
HOME ADDRESS '
AGENT OR CONTRACTOR '
ADDRESS %li'�S• /YtlllGt/it7/Y ��___-� /f/!/�D2� — ' �t fTEL.NO.r
This ap ication is for exemption of proposed exterior construction on the ground•that:
(1) It will not be visible from any way or public place.
❑ (2) It is within a category declared entitled to exemption by Old King's.Highway Regional Historic District'Commission.
(Check applicable box) -
1 PROPOSED'WORK: Describe and furnish plan of proposed work,showing location on lot,and, if an addition Is involved,show•
ing location of existing building.
i cL y/ G si�iNG 7'�e/M
•/�` G J
A
SIGNED
Space below.line for Committee use. Owner•ContractOr-Agent
e jv4bzH.§' The'Certificat 's hereby 2'`f�
to
r C
Tine '
TOWN OF BARNSTABLE. ' n
RU�QLQKING'S HIGHWAY Date
Approved categories of work entitled to exemption are listed on
Disapproved ❑ the back of this form.
f _
-+T� Ar
EXTERIOR ARCHITECTURAL FEATURES
.. SUITABLE FOR CERTIFICATES OF EXEMPTION
" FOR:RESIDENTIAL USE ONLY
FENCES: 1. Post and rail,split,half round or round;natural finish ' ;• '
2. Square rail;white or_natural finish { '
3..Stockade;natural or;gray stain finish;not forward of face'of main building
4c Pickets.white only . . .
s (Maximum height of all fences,4 feet)
HEDGES: ;;:natural,not to-exceed four,feet in.heighY; +'.
DECKS:': .6onstrUcted'of wood,on single family dwellings, built after 1900,'at first floor level,at the rear only;
,. railings-hot to exceed'30 inches-in height, not over.50%to be visible;from a way;natural finish or color
.' `compatible with building involved
'. BREEZEWAYS: enclosure of existing breezeways,consistent with style,material and color'of house,excluding sliding
glass doors facing street;way or public place
.. �. .- ,.. .� � '><.�•.t`�'K'{.�r.. `� .fit c,,"ti wa}•,.'�., ti ,. ,
.x.
FLAGPOLES: •. on residential property, not over 24 feet high,rnot less than 20 feet from way, constructed'of wood, with
natural finish,or.painted.white;or of aluminum,or of fiberglas or metal painted-White
ARBORS AND TRELLISES: of lightweight,wooden construction,.not over.nine feet'high
ROOFS: natural cedar shingles,.o.r asphalt shingles per approved color samples;not over five,inches exposure to
weather
SIDING: `.'' natural cedar.shingles,.or wooden}clapboards-natural or.approved color;not over five inches-exposure
to weather.
STORM SASH,-STORM DOORS;WINDOW SCREENS,SCREEN DOORS,GUTTERS AND LEADERS: permissible if
:consistent with style, material and.color of building.:,,, "
LIGHT POST: permissible if consistent with style,-material and color of building,
AIR CONDITIONERS:—portable,window'units at side or rear of building '.
STONE WALLS: construction of field or spliyone, not exceeding 30 inches in height
NOTE'
1. All prior bulletins hereby superseded. �-
2. Conditions contained in certificates of appropriateness shall be binding regardless of any exemptions contained herein, '
077
I
OME .IMPROVEMENT CONTRACTORS REGISTRATION
Board of Building Regulations and Standards t
One Ashburton Place - Room 1301
:Boston, 11assachusetts 02108
I
i
HOME IMPROVEMENT CONTRACTOR •-L--- -----------------
Registration 100740 Expiration 06/23/98
Type — PRIVATE CORPORATION
HOME IMPROVEMENT CONTRACTOR
E F4 Registration 100740
CAPIZZI HOME IMPROVEMENT, INC. I Type - PRIVATE CORPORATION
Thomas Capizzi , Sr . Expiration 06/21/98
1645 Newton Rd . I
Cotuit MA 02635 CAPIZZI HOME IMPROVEMENT, INC
Tholas Capizzi, Sr.
` Newton Rd.
ADMINISTRATOR Cotuit MA 02635
I
I'.. Ir (D•'y�j3Y '
`TFNa�..j�^'11;,iyi>_4xvY`ti'•.r:.... .i
DEPARTMENT
hil
ONC ASHM11
t
-='' a^ J;J •:. DOSTUN,
IkUG.r1ON�.SUMVISOR LICENSE
i....;: '>...''-1. Expires: .
,
�S�X�•��,GA�PIZ�IaJR: - "' , •
INS` BX'!,%P A` 02668 e� _
yyy'^ i
r =�- .The Commonwealth ofMassaehkseas
Department of Industrial Accidents
�z` 2 Offlcsil/ovaffathis
:,e
-11,-- 600 Washington Street
�r Boston, Mass. 02111
-' Workers' Compensation Insurance Affidavit 9
Applicant informations
C' 2z
location: 46 45KS cVA1
sit. 45:�;;d., 1� 4Zg<3S phonc a
I am a homeowner performing all work myself.
I am a sole proprietor and ha%e no pne %%orking in any capacity
I am an employer pros iding workets: compensation for my employees working on this job.
company name:
address:
city: ,1 phone N:
insurance co. ZZ �/�i'Z`T�/d policy N e8 ldE/3W %?4f
I am a sole proprietor. general contractor,or homeowner(circle one) and have hired the contractors listed below who have
the followin.-workers compensation polices:
company name:
address:
ct-. phone N:
insurance co policYN-.,-
company narn
address•
sit phone N•
insurance co Porky N
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a time up to S1,5M.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a flee of$100.00 a day against me. I■nderstand that■
copy of this statement may be forwarded to the Ofrice of Investigations of the DIA for coverage verification.
/do hereby certifj under t ins an a allies of perjury that the information provided above is true and correm
Signature ate C
Print name :]�E_f �f���7 Phone#
omcial use only do not write in this area to be completed by city or town official •
city or town: - _ _ permit/license N riBuildiog Department
0Licensing Board
O check if immediate response is required OSelectmen's OMCC
0Health Department
contact person: Phone N;_ �_ nOther
tre.ised 1/95 P1A)
- '^ Town of Barnstable
The To
> - Department of Health Safety and Environmental 5ern
Building -
367 Main Suet.HYaaais MA o2601
galph Crosscn
CT= Ma-79o-6227 Bung Cron
Fa= -AtW775-3344
For office use only
Pcmit no
Date AFFMAVIT H _
SUPPLENMN To pEERW APPLICATION
MGL c. 142A requires that the-Mwestrncion.alterations;renovation,repair- °v�aes ooi
impravemctn..re:no��al, ed
demolition. or constrmcioa of an addition to*any fch are ad}aoait
building containing at least one but not more than four dwelling vans or to other
to such resideioe or building be done by rz&crcd coatracors,with certain °� along with
i
v/N yL 511blA/46/;;
TT�C Est.Cost
Type of Work: x .�-
Address of
Owner.Name:
Date of Permit Application: -
I herby certify that:
Registration is not required for the follo%%ing reason(s):
Work coduded by law
Job under SLOOO
_Building not own -o=xpied
Owner palling awn Pit
Notice is hereby gn-en that:
OWNERS PULLING THEIR OWN PERMrT OR D WORK
DSO NOE�'�CONTRACTORS
TO M
• FOR APPLICABLE HOME DAPROVEMENi'
ARBITRATION PROGRAM OR GUARANTY FUND UNDER Ma-c I42A
SIGNED CINDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
7-1
motion No.
, Date � tractor �
OR '
3::
2 $ktt/STi�I G ��
: .'
900,0,
' yxG P•r' sr •
' r A cc
.eea"m
orb r.•JR
L in.rt v� 291Ak -,�
le-6 4111"
. .. .. 0 )/S4�en�it.t6��O.ff11•�
;tat. , • .. - -_
�—
Assessor's map and lot number .....'........I.. ......... SEPTIC SYSTEM MUSTfE
INSTALLED IN COMPLIANCE
/ WITH ARTICLE II STATE
Sewage Permit number ...... ,l (�D.................................. SANITARY CODE
AND TOWN
REGULATIONS,;
°fT"E.T TOWN OF BARNSTABLE
22
i BAHHSTADLt i
"b 9 �•� BUILDING INSPECTOR
APPLICATION FOR PERMIT TO
TYPE OF CONSTRUCTION ..... .. 4. .e.F!l.0 .......................................................................................
�.►-t:..:. . �. ..............19
TO THE INSPECTOR OF BUILDINGS:
The undersigned ``heereby applies for a permit
according to the following information:
Location .... l..l t o... 7S .� e.�.�..�..�e S�...... R Y���VJ`.e...t..� S:.....................................
ProposedUse ..... ................... ....................................................................... .........t....-..............................................................
Zoning District .......�... ...-.1=...�..........................................Fire District 1 �):QS.:i......( �'lS � .°�..<............
Name of Ownerll .' 1�Rd. .. `�1 ��... 4 N2-2— 1...Address o - 6 A �f� tle 3.! `4t SS
l CY 1 \
Name of Builder ��A.!eble..v �.��lan.P.`.` .1Address Ail. S:.S....!...� �.5:
I
Name of Architect ...- ...........................................................Address
Number of Rooms �( (
. ...............1..................................................Foundation .i.b......... .U�.�:1.!^.eC.....�.hCJ`�,-..1.Q,............
Exterior ....5....`...��.\�:�...................................................Roofing ....ITS. ..�1�:.\�......................................................
Floors ..,`........................................................Interior ....ss. 2C-��.......... ......................... ...................
Heating Q..Y�.S..e :. `�.:..W Y4 �.. ...............Plumbing ` �j .. o a ✓✓1 ..................
..........��. ....... .................................
Fireplace 2..>5.............................................................Approximate Cos .. :.:..
Definitive Plan Approved b Planning Board _____________________-_______19_______. Area
pp Y 9 `� .... '........
Diagram of Lot and Building with Dimensions Fee �9 .
SUBJECT TO APPROVAL OF BOARD OF HEALTH
ItloC-o _ S7`r� e—T
%
35 3 S 7
r
I hereby agree to conform to all the Rules and Re ulations of the To of Barnstable regarding the above
construction.
Name .... .. .. , .
Ga`nuzza^ Richard & Gail
'
16408
�
No .................. Permit for �"� --'' '
z , '
aiogle
— family dwelling------- (
- Vi l]Low. Street
—`-- ---^-----------------''
West Barnstable ' |
����,���������������������'.
` .
. �
Richard & Gail Gavazza
Owner ----________��^______.'�_.
fzazua
Type Construction ..........................................
` . . `
^` `
---.----------.------------. . .
' ^
Plot ............................ Lot ................................
'
^ �
�
Permit
Date of
| Inspection
uo/e Completed ^^
!
l.~ » .
PERMIT REFUSED
! .
-----`—_-------------. lV
, - ^
� ...................................... ---------'
^�/�
^---�-----~`.. ---------------.
'
.—.------.------------~----�-
^ ~ '
----.---------...~..---------,
'
^
: � ^
Approved ,--------------- lA
---------------..--.----.---.
`
`
� ------------------------.-- `
~
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. .'Y The Town of Barnstable
• BAMSrnet.E, •
9� `M �0�' Department of Health Safety and Environmental Services
prED Ma't" Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
October 9, 1997
TO WHOM IT MAY CONCERN: o
tlp
I have inspected the property located at 280 Willow Street, is,MA. There is no construction
occurring at that site.
Sincerely,
Xz-�
Richard Stevens
Building Inspector
RS/km
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