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Home My WebLink About0285 BISHOPS TERRACE Y.5" r,. �TME -Town ofBarnstable *Pao#1 q6 -3 Regulator Services Expires 6,nnnrks frnra issue dare .� M"Mcard V.Sca ,Interim Director 9� z639. Richard li Iti t , Building Division S 'd I Tom Perry,CBOT,Building Commissioner 200 Main Street,Hyannis,MA 02601 (Gti�;: rn - www.town.bastable.ma.us Office: 508-862-4038 Fax.508-7W623& EXPRESS PERMIT APPLICATION - RESIDEN I9, , STABLE Not Valid without Red X-Press Imprint Map/parcel Number T "c j Property Address Z��►� i S �S y�✓ytt e 6c l`�j`- a h I7.l'S ❑Residential Value of Work 0 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address_�� LIQ,,c '.K,i Contractor's Name `, r Telephone Number Home Improvement Contractor License#(if applicable) / U L, 3 w Email: 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, _Z ,`.L" o!Y Workman's Comp.Policy# 445� .51��1:7 - lT,/ 3 Copy of Insurance Compliance Certificate must accompany.each permit: Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) efRe-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 Are iced. SIGNATURE: TAKEVIN_D\Building g SS.doc Revised 061313 i r � , The Commonwealth of Massachusetts Department of Industrial Accidents 41 - Office of Investigations 600 Washington Street k� Boston,MA 02111 www massgov/dia Workers,,-Compensation-Insurance-Afrida-vit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ledbly Name-(Business/Organization/lndividual)._- ),,I 1-5-Laiad t, `��-� 4 �h�= Address: _`(� City/State/Zip: 4�ekl 4,Kv ` l�z. I<y�d� Phone#: `�' 7 6- cv Are-you-an employerMheck the appropriate-boz:.. Typeof project.(required):. 4. I am a general contractor and 1 1.( I am a employer with 6: ❑New construction employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. ❑Remodeling 2.❑ 1 am a sole proprietor or partner- ship and have no employees These sub-contractors have g• Demolition working_for me in any capacity,. employees and have workers' 9 ❑Building_addition [No workers'comp.insurance comp.insurance required.] S. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]fi 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 my employees. Below is the policy and job site information. r Insurance Company Name: Policy#or Self-ins.Lic.#: C �7� Y�� ( Expiration Date: Job Site Address: r��+.��` ��,rrae e City/State/Zip: eg k), MA A 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-ofa 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 .{i. e ' ' sdpenaes ofperjury that the information provided abov is true and correct Signature: Date: Phone# 3 Official-use-only. -IDo not>write in this urea;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 b.OtherT Contact Person. Phone#: -` i� , •z�- L, !'11'1 rJ1 (V1•ll—OJ rlt�ri: .luuuuo-Tu: 15Uti/ /bE)688 Page: 2 of 16 CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY)5/7/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED ATE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE BY THE POLICIES AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER FRANK L HORGAN INSURANCE AGENCY INC CONTACT 44 BARNSTABLE ROAD PHONE PO BOX 250 A/C No HYANNIS, MA 02601 ADDRESS: INSURERS AFFORDING COVERAGE NAIC q INSURED INSURER A: LM Insurance Corporation 33600 CAPE & ISLANDS CONSTRUCTION COMPANY INC INSURERB: PO BOX 210 INSURER C: CENTERVILLE MA 02632 INSURERD: INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: 20102526 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE I POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE OCCUR RENTED PREMISES _e occurrence) $ ME EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ JPERO LOC PRODUCTS-COMP/OP AGG $ POLICY❑ OTHER: $ AUTOMOBILE LIABILITY COM13INED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ A WORKERS COMPENSATION WC5-31 S-377540-014 5/7/2014 5/7/2015 ,/ STAT UTE ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 100000 OFFICER/MEMBER EXCLUDED? LNJ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 1 1 . T I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers'compensation coverage CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA 02601 AUTHORIZED REPRESENTATIVE d14' LM Insurance Corporation 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT No.: 20102526 Lucy Garfield 5/7/2014 7:38:38 AM (POT) Page 1 of 1 :RvsrnBLE; • t639. , Town of Barnstable ED Mpl A Regulatory.Services Richard-v,Seati.lnterim-Director Building Division ThomasTerry;CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www:town:liarns"table.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 /�/ � 4 6611 W`qo act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) J /J j MgmtKre of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. TAKEVIN_D\Building Changes\EXPRESS PERMMEXPRESS.doe Revised 061313 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,AIA 02116. v d w hoot signature .... ,per.__. ._-. �/ze�o�ninzo?iusea�a�Caac/zuaelta `'i - -Q\ Ofrke of Consumer Affairs&Busiuess.Regulation. ME IMPROB/EMENTbONTRACTOR egistration 165936' Typed xpiration 4_-L9/,2016 - _ Private Corporatio z� -->=M II CAPE 8-ISLAND.CONSTRUCT ON;CO INC. yi i - ' . JOSHUA;KOU.RI ` 55 ELM AUE HYANNIS MA;02601 V� Undersecr etaf. i Massachusetts -Department of Public Safety Board of Building Regulations ulations and Standards Construction Supen-isor License: CS-074660 JOSHUA X KOUIRt i PO BOX 210 , CENTERVILLE MA 121533 Expiration Commissioner 02/12/2015 contain less than 35,000 cubic feet(991M )of enclosed space. - Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: Www.Mass.Gov/DPS Assessor's Office(1st floor) Map Lot Zf-d. C-A,_�Permit# Conservation Office(4th floor) Date Issued Board of Health(3rd floor)(8:30-9:30/1:00-2:00) Fee A�d e-V Engineering Dept. (3rd floor) House#1 n::�, g. Planning Dept.(1st floor/School Admin. Bldg.) • BARNSTABLE. Defini2.anroved by Planning Board 19 e9TOWN OF BARNSTABLE Building Permit Application Projectss 2 %5 4 s Te,�z�9c 7/ 114 s Village Owner 3oSPpH /-1/ AlnoLey Address Telephone Cf. /.7-3 Z Z— Permit Request "s e: a Total 1 Story Area(include 1 story garages&decks) square feet `�� Q)V � Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost /o 00 Zoning District Flood Plain Water Protection Lot Size ' �'3 ff cne_ Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential e Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished yc.s Historic House Unfinished Old King's Highway Number of Baths a No.of Bedrooms 3 Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached rjcs Barn None Sheds Other Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# 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 SIGNATURE hti DATE BUILDING ERMIT DENIED FOR T44601 LOWING REASON(S) I + { f FOR OFFICIAL USE ONLY PERMIT NO. #8954 " DATE ISSUED July 17, 1995 r MAP/PARCEL NO. 251. 182 ADDRESS 285 Bishop's Terrace VILLAGE Hyannis, MA 02601 OWNER Joseph M. Mealey { _: DATE OF INSPECTION: FOUNDATION _ r + FRAME _ + INSULATION FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH x FINAL I GAS: ROUGH FINAL FINAL BUILDING s i { • DATE CLOSED OUT { ASSOCIATION PLAN NO. + �oFTHE r Town of tfj§ ke i ABLE STAB . Regulata 2§tFjiFe§ 10. 42 BAMv� Mass, $ Thomas F.Geiler,Director 1639. A Building Division Peter F.DiMatteo,BuildingLg4i �joner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 J� 6 PERMIT# ldW FEE: $ w.�� SHED REGISTRATION 120 square feet or less Ic Location of shed(address) Village �'ose,� M c C� EL /t'/E✓9Le y �So� -7 2,P, /Z 7 Z Property owner's name Telephone number /d 1< /Z 2S�0,02 1-07G 2 Size of Shed Map/Parcel# 3`2��/6 ign a Date 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. l THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 a\ppLiGa�i 2G�_�I i FZ� .�'d��at E=We r 0- 51088 t3K= L.C.'7�g99 P&G&: 12 1 specclot-L `1�20��G?�G►�` Lot 60 Z06 61 155.44' wravot V Z Stor 0welk7 o -191 I 8 141" M6.25' Lot 6¢ 1 GelZCJF0 CbNr, -d2LS Plat'2 bNz seen Pt rop- KaCaFrt2atZ. a4id BErm6Cc ��tH t2E &oeL,ur)& sr)owrz t2�ota&es r= FAij- In g� eAU s� f a slecaat_-FEx12.&.Fiood hazes aka. FOR C•Al•Y2CY2Z mu-i OF: 133Q12� BI.� R VET u � .3 31 � wttI2 an EFFemve de%m oF:a AG. 19, t985 s� xt)e toc,3,wtl of d-w-, &mAjjri& aPVEa s o sutra° m cor?wmaco 0-�e iom-zormw Bu-laws ire t x:; z oorzs w rct2. twsvecz�CD bomzonraL dtm muona►L w=c;%.il Wzx ! us- cMs piarilax%s rx:)z n FOR P UX2- �ni � FX.1PJi 05eS MFAQC.1SE W2 Paept-N Zlm deed &-SCaPCICT2S. VeVY1FtC&ZX0t2 OF PR?PeQUO OFF F�£� d.1r2F. d1fYIEC2StOt'2�S, BC-1ilLjlr2G SF�s, 269 �'�r20VEu.v ' op 10C ConFt6UZND0rl 1WO I��12PLSr� �n�sa 02339 Ot?ly &;j anaCCGtQ3re t -5CI�• P1ZOtif, ron 826-7t86 11J0V94 17:02 $8177277122 DEPT INTD ACCID ' ConunaZcuealLli of 1Wa6.jac1euse& ' ..C�apartineref o��n�friaL�eeuiants � 600 1Naduat son Simd James J.Campbell &Ion, ///amaducu >Ei 02f f f Commissioner Workers' Compensation [ftsumce Affidavit with a principal place of business at: Y ��e w.-. ��,.�..�� 7��.�•�e-, �-j/f sue' �z�s6� — ectnsraee�sta) do hereby certify under the pains and penalties of perjury, that: q I am an employer providing workers' compensation coverage for my employees working this job. insurance Company Policy Number () 1 am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and-have hired the contractors listed below who have the following workers' compensation policies. Contractor Insurance Company/Poficy hlumbe Contractor Insurance Company/Policy Nulnbi Contractor Insurance Company/Policy Numbe I am a homeowner performing all the work myself. I understand that I cot;y of&,is srate.-nent will be forv:arded to ti:e Office of Invesdeadons of the DIA for coverage Verification and that failure to! coverage:s rec i,Ied under Section 2SA of MGL 152 can lead to the Imposition of criminal penalties eottsisdat;of a fine of up to s1,500.00 Inc Years' im;ri<ormgnt as well as civil penalties in ttte form of a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this day of l �/ cT'� Ly Licensee/Permittee Building Department Liaising Board Selectmen Office Health Department Y., •rr n try a^1 f="a r:T: TIM en a M e-rrnv r e 1 1 • A a 7-727-4900 X403. 404. 405, 409, 37 • `. TOWN. OF' BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE t JOB. LOCATION Z gs g�C?r Number Street address Section of town "HOMEOWNER" .... 2 32 73 77 37i�. Name Home phone Work phone -- PIRESE:`IT FAILING ADDRESS L� = �79SS9c��sel7s City State Zip code The current exemption for "homeowners" was extended to include owner occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six 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 Stat Building Code .and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a persons) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction' Supervisors Section 2. 15) . This lack of iwarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home"dwner, actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully z.ware of his/her responsibilities,. m3n communities require, as part of the permit application, that the Home *Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. : . You may care to amend and adopt such a form/certification for use -in your community. The Town of Barnstable mom• a►Rrvernm�. • tee$ Department of Health Safety and Environmental Services &659. Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790-6227 Ralph Crosses Fax: 508-775-3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME E"ROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner aocuPied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: e — 20 0 ;, Est Cost''/0 00 Address of Work: R%s 4.P s 7e�A,¢,-e A/7,g n/?f�s t?wrrer.Name: S SeP /`i�c��L Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000 Building not owner-occupied P%,.mer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL C. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor name Registration No. OR Date Owner's