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Home My WebLink About0012 CAPTAIN COOK LANE - - - - -3q Ll y q>o k 11 e C�ncQOs 1 i�—I3.�U Application number..............-................... .� I Coo : 0.� . QaFee ........:.................................................................o. MAY 03 218 Building Inspectors Initials...... NAM - ................... wSI AW Date Issued.: .........................1.:IR ®r l� r1 �a1 Map/Parcel......�. ..!.......V..I.........O.O.�........ �- tjAMS46WV OF BARNSTABLE ®� EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 1 a +2,k. ecck 2sak`�S ER l- =T VMLAGE . Owner's Name: 2s C l�-�� n�z� Phone Number Email Address: Cell Phone Number Ste' 3L,q Project cost$ L{� LC�. Check one Residential � `"` Commercial OWNER'S AUTHORIZATION As owner of the above' operty I hereby authorize G � `� . e to make application fo building permit in accordance with 80 CMR Owner Signature: i Date: u 1 TYPE OF.WORK idin l=1 Windows no header change)# ❑ Insulation/Weatherization g ( Doors(no header change)# l Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to ` CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable) (attach copy) Construction Supervisor's License# 00 3 L'ly (attach copy) Email of Contractor l2l�e� �l Phone number 12�-"�j6--`Fg70 ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY 1S IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER....................................... ..,►.... ..Y.... ; *For Tents'Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or>Yes No ,if yes, a gas permit is required. Natural Gas Yes No , if yes,a gas permit is required. . If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. i Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date q-22-0 Al permit applications are subject to a building official's approval prior to issuance. . ' . Town ®f Barnstable Building Post This Card So' o That it isUisibleiFrom.the Str."eet Approved PlansMustbe Retained on Job and this Card:Must be Kept 'w' BAIL BLB, -b `�$ PostedUnbl Final Inspection HasBeen Matle . - . Permit Bbr Wherea Certificate=of,Occupancy is Requed,suBu Idmgshall Notbe Occupied;until a Final Inspection has�beenmade Permit No. B-19-1350 Applicant Name: GEORGE W. BLAKELY Approvals Date Issued: 05/06/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/06/2019 Foundation: Location: 12 UNIT 12 CAPTAIN COOK LANE, HYANNIS Map/Lot: 274 014 OOK_ Zoning District: SPLIT Sheathing: Contractor Name GEORGE W. BLAKELY Framing: 1 Owner on Record: SHECHTMAN, RICHARD B&GARY L $ g Address: PO BOX 4 `, Contractor�L ense104514 2 PE BARNSTABLE, MA 02630 " Est Project Cost: $4,100.00 Chimney: Description: Siding,Window replacement(4) Door replacement(1) Permit Fee: $ 160.00 '. Insulation: Fee Paid $ 160.00 Project Review Req: fi Date 5/6/2019 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 siz months after,issuance. All work authorized by this permit shall conform to the approved appl ation and_4h approved construction documents--.for which is 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' y,laws and codes. �� . F ., Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public mspecton for the entire duration of the work until the completion of the same. = Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Budding and Fire Official are provided'on thisspermit. Minimum of Five Call Inspections Required for All Construction Work: • Service: 1.Foundation or Footing 2.Sheathing Inspection � Y`. �r �� 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. 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). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: 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/Organization/Individual): Address: bC City/State/ZipU 0,-30 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I a employer with 4. ❑ I am a general contractor and I ployees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- _ listed on the attached sheet. 7. ❑Remodeling shipand have no employees These sub-contractors have g _ ❑Demolition working for in an ca aci 'employees and have workers' g y p ty. 9. ❑Building addition [No workers' comp.insurance comp.insurance.: 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its 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.❑ of repairs. insurance required.]t c. 152,§1(4),and we have no. employees. [No workers' 13. Other' _ comp.insurance required.] •F *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: 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 un r e pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#: 3 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, §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( )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#617-727-7749 Revised 4-24-07 wwv.mass.gov/dia Z Center Village Condominiums 508.420-7472 Fax420-7347 % The SouthCape Assoc. P.O. Box 671 TRUSTEES:Margaret Nichol,Marie Waish Mashpee, MA 02649 Sharon Bell, Phyllis Cazeault,Jeff Hynes Date. 04/25/2019 -- --•-� Subject - ---� Town of Barnstable Building Department Window Installation To whom it may concern, This is to verify that Rick Schrectman, Owner of unit 12 Captain Cook Lane, located within Center Village Condominium Trust, Centerville MA has been granted permission to install Harvey Replacement Windows within his unit. It is understood that no structural changes will be made during this installation. Mr. Schrectman or his contractor will be obtaining any permits as required by the Town of Barnstable for this work. Sincerely, Justine M. Dionne, CMCA,AMS Managing Agent, for BOT Center Village Condominium Trust i . 26.2019 02 : 09 PM The SouthCape Associates . 5084207347 PAGE. 1 Center Village Condominiums 508.420-7472 Fax 4.20-7347 %The SouthCape Assoc. P.O.Box 671 TRUSTEES:Margaret Nichol, Marie Walsh Mashpee, MA 02649 Sharon Bell,Phyllis Cazeault,Jeff Hynes Date: 04/25/2019 —1 Subjed Town of Bamstable Building Department Window Installation To whom it may , y concern This is to verify that Rick Schrectman,Owner of unit 12 Captain Cook Lane, located within Center Village Condominium Trust, Centerville MA has been granted permission to install Harvey Replacement Windows within his unit. It is understood that no structural changes will be made during this installation. Mr. Schrectman or his contractor will be obtaining any permits as required by the Town of Barnstable for this work. Sincerely, Justine M. Dionne, CMCA,AMS Managing Agent,for BOT Center Village Condominium Trust eao�Unaaria�ealC/t 6vaciau6elCl Office of Consumer Affairs&Business Regulation Registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: TYPE:IndMdual Office of Consumer Affairs and Business Regulation _R eai i tion n Place-Suite 1301 tio One As hburto 1`0451.4— 07/13/2020 Boston,M 08 GEORGE W•Bt WELY - 3° GEORGE W.BUIKELY' 1$/ �'Q NOt alid withou s gnatuire 130 REDWING LN/pp��BQX'206 BARNSTABLE,MA 02630 Undersecretary s Commonwealth of Massachusetts t t Division of Professional Licensure Board of Building Regulations and Standards Constrhot6iv§ lisor j. CS-014344 a Spires:03/20/2020 GEORGE W BLAKELY*�.,,j 130 REDWING'LN/PO,BAX/206} BARNSTABLE MA 02630 Commissioner l i .