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0009 CASTLEWOOD CIRCLE
� � --- - I / i Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 2/25/16 BUILDING DEPT. Town of Barnstable 201E Thomas Perry CBO FE� Building Commissioner 200 Main St.Hyannis,MA 02601 -rO\NN OF BARN67A6�- RE: Building Permit#B16-106 TO: Building Inspector(s), e This affidavit is to certify that all.work completed for 9 Castlewood Circle,Hyannis has been inspected by a third party Certified'Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, r William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map o Parcel © 6 b T07VN OF BIARNSTABLE Application ## Health Division z f nj t Date Issued Z"f —�CP Conservation Division Application Fee � •� Planning Dept. Permit Fee 35100l Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address e Village a,nn Ids Owner 6 Address 1;, cyneP Telephone 50, a` Permit Request f4j R- M, A i 11 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 5 D D 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ,❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes *, No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) NameNUML, AC_, Telephone Number Address License # -1-G 10 1• f0.1-rr%0a , , M ! 6 Home Improvement Contractor# 1+)3?f6 Email Worker's Compensation # V C 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY u APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER f 9 , DATE OF INSPECTION: T ' FOUNDATION FRAME INSULATION FIREPLACE r r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: . ROUGH FINAL ` FINAL BUILDING DATE CLOSED OUT E ASSOCIATION'PLAN NO. 5 HOME OWNER WEATHERIZATION WORK PERMIT: f , PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. I Z — hereby consent to and agree that weatherization work may be done by the Weat erization Program of Housing Assistance Corporation on the property located at: 4. cc,11+� C �c �� N C.- The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping;air sealing; attic&basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. 1 give permission to Housing Assistance Corporation the property with such equipment and materials as may be necessary to perform weatherization. j 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for i the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. j I have read the provisions of this agreement and give my consent. Home Owner(signature) Jr Home Owner email: ' - h Date: Agent:(signature) Date: Weatherization Contractors: Adam T Inc Cape Save All Cape Energy von ier nergy Solutions Alternative Weatherization Lohr Home Improvement !Building Science Construction Resolution Energy Cape Cod Insulation Tupper Construction t r 1 ° 31 �.... .t�� •.`, •j•1... . t _A'f..a ..•,. �t Fyt.l ,+b_ nr- .. ;The:Commonwealth of Massa ch use. tts } Department of Industrial Accidents' 1 Congress Street,Suite 1.00 ^.' 7:� ;Il ut. S' Boston,MA 02114-2017' u<'� � ` ;114 - y www mass gov1dia - NN%rkers'Coutpensation Insurance Affidavit:Builders/ContractorslElectricians(Plumhers. TO BE FILED WITH THE.PERMITTING AUTHORITY. Applicant Information Please Print Legibly , e Save Inc y1 NameName(Business/Orgatiization/Individualj: .Cape Address:7-D Huntington.Avenue. ,,1. ,•_.•„ City/State/Zip:South Yarmouth, MA 02664 r, phone#:508 398-0398 f Are you an employer?Check the appropriate bog: —Type Of ro act r. aired 1 . ._. P 1 (.e9 _ ) 1. ✓Q I am a employer wnh 20 +';'-employees(full an0pi pact-time)° `r M �, ,j, Q New construction z yl- - -• 1 2. I am a sole propnetoi or partnership and have no employees working for me m ` ,:t g D Remodeling , nce re any capacity.[No.workers'comp.insuraquired] 9: ❑, r ram, Demolition 3.[]l am a homeowner doing all work myself[No workers'comp.,insurance required.]t . 1_ [`Building addition : 4:❑I am a home6%•6er and will.be hiring contractors to.conduct all work on r6 property. I will v `_ ensure that all contractors either have workers'compensation insurance or are sole 11.Q.Electrtcal re' patrs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 50 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. t 13:❑Roof repairs , These sub contractors have employees and have:workers'comp.insurance.t ' 14. Other + 6.❑We are a corporation:and its officers have exercised their right of exemption per MGL c: Insulation _ i 152,§i(4),and we have no employees.[No workers'comp.insurance required,] , t _ *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 ail,work and then hire outside contractors must submit anew 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 3 } 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:Wesco Insurance Company Policy#or Self'ins.Lie:#.WWC3136274 Ex irationDate:04/09/2016; 'i _ P - spa Job Site Address: 9 Castlewood Circle - City/State/zip; Hyannis .. . -•Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). i Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00 4 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 t day against the viol.ator:A copy of this statement:may be forwarded;to the:Office of Investigatioris of the DIA.for insurance coverage verification. , °.'. .' - 3: , . - .. . I do.hereby certi . under th atns and enalties o er u that the information provided above is true and correct I 3' 1Y P P fplry. f P f �.. - 1, Si aturea Date: 127/16 ' Phone#:508:-398 0398 -Offhcial use.only."Do not.write in-this area,to be completed by ctty'or to►vn`gf &al."__ -_ Ct'yor,Town, 3 -.�}��� : r _ PerinitlLicense Issuing Atithor►ty.(eirc10 one), .►�s.. 4.e t, •'' 1 ic'r=- , _ ,tt -- 1.Board of Health 2 Building Department 3.City/Town�Clerk 4.Electrical Inspector 5 Plumbing.Inspector.i, .; 6.Other Contact Person:. Phone#: ' J�' �••.'}Y '♦ �.e, 46 J l ® DATE(MMfDDIYYYY) ACORl7 CERTIFICATE OF LIABILITY INSURANCE �. 10/14/2015 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 BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)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. PRODLCER CONTACT NAME: Colleen Crowley Risk: Strategies Company PH0 E (781)986-4400 FAC No:(781)963-4420 WC No.15 Pacella Park Drive E-MAIL ccrowley@risk-strategies.com Suite 240 INSURER(S)AFFORDING COVERAGE NAIC f Randolph MA 02368 INSURERA:Selective Ins. of America INSURED irsuRERs Allmerica Financial Alliance Ins Co 10212 Cape Save, Inc INSURER C:wesco Insurance Company 7 D Huntington Ave INSURER D: INSURER E: South Yarmouth MA 02664 INSURER F: COVERAGES CERTIFICATE NUMBER:CL15101402127 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 LTR TYPE OF INSURANCE POLICY NUMBER MPMDDO� EFF MPMO'DDI EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTEff- A CLAIMS-MADE Fx_1 OCCUR PREMISES Ea occurrence $ 100,000 91994480 10/16/2015 10/16/2016 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY r— I PCT [X]LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ j AUTOMOBILE LIABILITY Ea COMBINEntSl L $ 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED M SCHEDULED ANNA46796600 11/6/2015 il/6/2016 BODILYINJURY(Peraccident) $ AUTOS EX HIRED AUTOS NON-OWNED Per ecadeYntDAMAGE $ AUTOS UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DIEDRETENTION Nil S1994480 10/16/2015 10/16/2016 $ WORKERSCOMPENSATION OPfioers Included for X PERT O AND EMPLOYERS'LIABILITY STAUTE ER_ ANY PROPRIETORIPARTNEWEXECUTIVE YIN NIA Coverage E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMC (Mandatory In H)EXCLUDED? WWC3136274 4/9/2015 4/9/2016 (MandatorylnNH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more apace is required) National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial Gas Company and NStar E_ectric are all included as Additional Insureds with respects to the General Liability coverage of Named Insured as required by written contract. CER71FICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Housing Assistance Corporation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 460 West Main street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 - AUTHORIZED REPRESENTATIVE Michael Christian/CLC "� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401) f Office of Consumer Affairs and Business Regulation yyr` 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Co-ntr`actor Registration Registration: 171380 _ Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. WILLIAM McCLUSKEY -- 7-D HUNTINGTON AVENUE Al �. ' SOUTH YARMOUTH, MA 02664 = ------------- txa � Update Address and return card.Mark reason for change. SCA 1 0 20M-05/11 E] Address E] Renewal 0 Employment E] Lost Card o�/u`�r n�oiuwcu�etclG�,����.u.uur�ccie/L� Office of Consumer Affairs&Business Regulation License or registration valid for individul use only BIOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: �713gp Type: Office of Consumer Affairs and Business Regulation Expiration 3/14/�2-16 Corporation 10 Park Plaza-Suite 5170 � y Boston,MA 02116 CAPE SAVE INC. ;K ' WILLIAM McCLUSKEY _ 7-0 HUNTINGTON AVENUE SOUTH YARMOUTH,MA 02664 Undersecretary Not vali Tt signature Massachusetts-Department of Public Safety Board.of Building:Regui:atians and,Standards t.11111t1 ti1'tl�/Ii.JIl11G1Y1.�1t1'Jttt.11''AILY '.;, �rv� '- License: CSSL 102776 1 e , WILLIAM;dMC"W 37 NAUSET ROA10) .111 ,- IF West Yarmouth IWA Expiration Commissioner 061=2017 Y . Ft1ME r Town of Barnstable , *Fermi 4 4/ O q 0 ILIA Expires 6 months j n'su ate Regulatory Services Fee + BARNSTABLE. 9� Mass•1639. Thomas F.Geiler,Director �0 Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.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 Z 73 Property Address g_ 4,51 a Z [. 'Residential Value of Work / O Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address H Iq O-e— e l dy 4 C l 2- Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) ' Construction Supervisor's License#(if applicable) �1?e ®Workman's Compensation Insurance Check one: ❑ I am a sole proprietor i.am the Homeowner 7*0 ❑ I have Worker's Compensation Insurance N®F 's, R/V,9T Insurance Company Name � _ A L� _ Workman's Comp.Policy# # Copy of Insurance Compliance Certificate must accompany each permit. - Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to ❑Re-roof(hurricane nailed)(not stripping. Going over ' existing layers of roof) ❑ Re-side I #of doors ETOReplacement Windows/doors/slide .U-Value 0 ' (maximum.35),#of window ❑;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: . � E C:\Users\decollik\AppData\Local\M rosoft\Windows\ porary Internet Files\Content.Out]ook\QRE6ZUBN\EXPRESS.doc .Revised 653012 r e y The Coraaruortivealth of Massachusetts _ r -Department of Industrial 4ccitlerats - Office ofInvestigadons 600 Washinglon Street Boston,AM 02111 � - Wis ov.rrrassg�n/aria Workers' Compensation Insurance Affidavit Bttilders/Contractor i aicians/Plum hers Applicant Information Please Print LedbI� Name(SusmessiOrgau za€iondudimdual): Address: �/ a � C tyCState ZYp: !f wN i 26a/ Phone,* S^O � 7— Are you an employer!theck the appropriate box: Type of project(required): 1.❑ I am a emp'!oyer with. 4. ❑ I am a general contractor and I r * have hired the sub-contractors _ ❑ s ion employees Mull andor part-time).* . 1❑ 1 am a sole I� or o etor partner- listed'on the attached;sheet. 7- [ modeling . 1� ship and have no employees These -contractors have g. ❑Demolition working for me in any capacity employees and have workers" �_ Building addition [No workers'comp.insurance. - comp.insurance ired_j 5. ❑ We are a corporation and its l O}❑Electrical repairs or additions 3.KI 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_]= c_ 152,§1(4� ands*e have no employees_[No workers' 13❑(tither comp_insurance rewired_] •Aar applicant that cheEks bog#1 trust slam fiIl out the section below showing shear worlien'compensation policy information- t Homeowum who submit than affid4Mt lnd camhg they are doaae all wed and then here outside contractors must submit a new affida rt indicat m.-such_ 1 =Contractors that check this box must attached an additional sheet showing the uam a of the subs-contractors and state whether or not those entities have . eaVloyees. If the sub-soatracrots have employees,they must prm-ide their workers'comp.policy number- lam art employer tltaat is providing workers'compensation insurancefornty,eniplo ees Below is the pelt y and job site - irrforrraatioats � ` Insurance CompanyName: _ Policy 4 or Self-ins-Lic.g Expiration Bate: � Job Site Address: CitvStater°Zrp: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date)., Failure to secure coverage as required.sunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 andfor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$2 50_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. Ida hereby certa ran4 or7_,7 d rtabies ref perm}that the information provided abase is trace areal correct., Si Lure Bate: I z• zrVV J t Phone#: 2-- Official fase only.'Do not write in this aria,to be completed b}citJ•or town of ciaL , Citti or Toa ru: PermitlLiceuse# a Issuing Authority(circle saes: , 1.Board of Health 2.Budding Department 3.City(Iown Clerk 4.Electrical Inspector 5_.Plumbing Inspector 5.Other Contact Person: Phone#. .a • _ 6 �tHME r Town of Barnstable Regulatory Services . S,mILF Thomas F.Geiler,Director Hasa 1639. a,• Building Division fn � Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 i www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508- -790 2 63 0 HOMEOWNER LICENSE EXEMPTIO N Please Print DATE: ' 1G JOB LOCATI N: n b r street, village h _z-. S �. 95 zz ..HOMEOWNER": �5� �� (� � 6 name -home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellines 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 applicable codes,bylaws,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. Signature of Hom 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 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-t amend and adopt such a form/certification for use in.your community: Q:forms:homeexempt 'ME Town of Barnstable Regulatory Services RAMSUBM `�� Thomas F.Geiler,Director s63q. 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 Arid Sign This Section' If Using A Builder l as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit: (Address of Job). Pool fences and alarms are the responsibility applicant.onsibili of the Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS 6/2012 TOWN OFBARNSTABLE BAR-W 3649 Ordinance or Regulation WARNING NOTICE i Name of Offender/Manager _ A " 7' �,r►,t j Address of Offender E s.! t.x.� �;; r �"�, MV/MB Reg.# Village/State/Zip 1-1 y, 4, ,',*f �► . , ## 4 Business Name M/pm; on os /a 20 03 Business Address '`" ✓' ` Signature of Enforcing Officer Village/State/Zip Location of Offense S 7C r t, ,n e, 47 9 Enforcing Dept/Division Offense IV 6 6 wl /Z Lam "r; r+c /6 /),o yc 7<< Facts -7S G t': 4 /M • 0 This will serve only as a warning. At this time no legal action has been taken'.,. It is the goal of Town agencies to achieve voluntary compliance of Town6 ',,' ._. Ordinances, Rules and Regulations. Education efforts and warning notices are-; attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./.REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. I u, - + _ Town of Barnstable Regulatory Services CF THE 1p� 1% Thomas F.Geiler,Director Building Division anaxsrnai.e. 9� MASS. Tom Perry,Building Commissioner iOrfD Mp2l A 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: / HOME OCCUPATION REGISTRATION Date: Name: Gam-(-�l,<Q,G l�cM' d f Phone#:—(1 G Y Address: I CAA f V 1-0 `�'���� Village: �Jfg_A S —( P a L C Name of Business: r; t s 4 a v'A- h 'a_�' „� S a� f- /¢IZ{--3 Type of Business: 4CC-6 k Map/Lot: 7-3 V CQC INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation ~ within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual ; alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector, a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit, located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials, in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the.Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,hav read and agree with the above restrictions for my home occupation I am registering./ Applicant: Date: Homeoc.doc Rev.5/30/03 TO ALL N W PUSINESS OWNERS DATE: G5 7 lag Fill in.please: APPLICANT'S ° a° �. YOUR NAME:' USI ESS �� � ��r� S-c�S ;b YOU HOME ACJDRESS: P_wd®d. TELEPHONE " e Tele 'one Number Home 33. NAME OF NEW BUSINESS s TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YEST NO C.m N S u Have you been given approval from-.t a b.uil ing division? YE NO � ADDRESS OF BUSINESS ___ MAP/PARCEL NUMBER D When starting a new business there:are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended tp�iassist you in obtaining the information you may need. Once you have obtained the required signatures, listed below,you may apply for a business,bertificate at the Town Clerk's Office (Ist floor-Town Hall). You MUST go to the following office to make sure you have all the required.permits and licenses.. GO TO 200 Main St. - (corner.. rmouth Rd. & M e ) and you will find the following offices: 1. BUILDING COMSIG ER' FFICE. This individual has en me f any p q emen s that per-rain to this type of business. A izers ignature Zn a J 1A t1,10 2. BOARD OF H H This individual ha b ini-o. d -mit eq�u re e s th pertain to this type of business. u orized Signature* COMMENTS: 3. CONSUMER AFFAIRo-(LICENSING AUTHORITY) This individual ha n i;�for of the ?n? r uirements that:pertain to this type of business. Authori 'd Signature COMMENTS: Business certificates.(cost$ .00 for 4 years). A business certificate C:NLY REGISTERS YOUR NAME in the town (which.you must do by M.G.L. -it does not give:you permissRn to operate you must get that through completion of the processes from the various departments involved. **S/GN/F/ESAPPROI/AL F0,03 9 BUSINESS CERT/F/CATEONLY. _ ® _ 2 73 de PCB �//��` -3 SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE �,�., WITH ARTICLE II STATE �'�c� .`HE, &°�°- �.. SANITARY CODE AND TOWN b�Q�OF7HET WN F BAR:NSTXB IES. i BA$B9TADLE, • "6 9 0 M �•� BUILDING INSPECTOR PY p,. lVe4 ar C C 12-AoA F X-0o 6?4121KC APPLICATION FOR PERMIT TO ..... .4�.!?LS. .. :..T............. .P...P.1..T.. ..................................... TYPE OF CONSTRUCTION ..!2Q.;7. ........J.....��/9.!''((',,,,,,,,,,,,,,,,,,,,,; ................:.................... .� (...........2.............. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...................................... S .T .1 t-c� ?.0.. ........ .t..��. ............ ..1.y�.! .! .LS............................... ProposedUse ................... ....................................................................................................................... � Zoning t District .........R- ... ...................................Fire District ..... . :Y .IV .. .5............................................. Nameof Owner PlA.1K.n.9...... ......Address .................................................................................... Name of Builder C--0Z.45-..1.R.1.1.<:.T.CQA.....Address .�.�s....1�...�.?C.....��.:..7................... .1.��.. Nameof Architect ......... .t. C.........................................Address .....................................:.............:................................ Number of Rooms .....OM. .L'..........CAL.VS........R-.Q.C,8....Foundation .. - .G �.................................................... Exterior .......�!...0 .'... r.......................................................Roofing Z7 t` ?LT.......................................................... Floors ..........C.A.K.F.C-.7..................................................Interior ...... �,........��. � ...... �?�.1C ................. Heating ......Ft..W......6.1(K.......... .Y....G 6.5..........Plumbing .....42t L......+v�. 11 H...................................... Fireplace .............. .........................................................Approximate Cost ..... .�. ....,/V. ............................ Definitive Plan Approved by Planning Board ________________________________19________. Diagram of Lot and Building with Dimensions / Z j s SUBJECT TO APPROVAL OF BOARD OF HEALTH I I�LuJ 13aiN ( LoT r� x EX 1 STl nl G oReFt -� CARPOP,7- I 7-® " i I hereby agree to conform to all the Rules and Regulations of4thenns able re rding the a ove construction. Name .... . ` . , uphsroaa Martin ' - AI - ' No .. _ Permit for __eTloom ca ort � � � add to . -------------~------'��---- � Locationg__Cy ..CircIe______. ' ! ------'..«/*?ll#P--------------. Owner --.���}������������--------. Type of Construction -----.��Y���----.. � . -----.—,------------------. ~� Plot ............................ Lot ................................ ' � . 73 J`�� I3 ? Perm PermitG,on��6 --^ l0l ---------'---. ) � � � Dote of Inspection ---,---. .lP ' ~~'~ Completed .� u . . ` PERMIT REFUSED ' -----'---------------- lg / � ----.----------------.----.. � ! —_-----------------------... -------------------_------ .-------.------------------. � Approved ............................................... lg ^ ' ~^�- � -------'---------------''---' � v^ � ------------------------~... � � � � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION w� Map 2 3 Z� Parcel Permit# Sf/ Health Division 11)6 Z ' Date Issued ate_ Conservation'Division s Application Fee Tax Collector 0Q;3 © k IV L — b�p r _ .' Permit Fee Treasurer . �t `'S aI3TO3G ll�� 00 r—TD!> Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address -T eow712e em.. Village Owner Address /37 ��- Telephone L or 77/ m 8" - Permit Request_ v � , _ S-0-0A & 5- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 's ®�. Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 1�1[ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: N Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.fft) " Number of Baths: Full: existing 7— _' new, Half: existing new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: 17Gas O Oil ❑uElectric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing, ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new 'size Shed:❑existing ❑new size- Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use ' Proposed Use T1. BUILDER INFORMATION Name d Ift ,Je ft r4 Telephone Number S I'J Address — q e. ¢1 s i f �a� • C <. License# ? ' Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Z03 r FOR OFFICIAL USE ONLY ti 'PE!tbMIT NO. _r wQ DATE_ISSUED MAP/PARCEL°NO. t ADDRESS ' VILLAGE ' OWNER A + x DATE OF INSPECTION: FOUNDATION - FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL•r� PLUMBING: ROUGH FINAL GAS: ROUGH FINAL' l' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t The Commonwealth of Massachusetts �i - - - Department of Industrial Accidents -- Office of/fiYesUffatfoos _ — 600 Washington Street r Boston,Mass. 02111 ' Compensation , .. ,e davit Workers Insuranc �rr/.l�l�lr/,��!/���(„ •�''�'�//%%%%%%/O/%%%%��%�%/O%%%��%�/, ,,,,,„ ,. �'/���O��O���/O/O��//�O�O��/O//D//O�0��0���00��/O/O�O�O�. name: location ci hone# l I I am a hom&wner performing all work myself. ' ❑ 1 am a sole rietor and have no one worku in ca acity ❑ I am an employer pravldulg workers compensation for my employees wor : g:on this::::::::: ° ..:. : ;:;;;:;;:::;:::::;:;:>;::>;::::;:::<::;: :cons an n ... ::::::::..:.::.:. ..::.....:: .. ....:........: %/ ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices; :con► an .........me :.. a1S. 'i?�� � ::.. addre ;w X. ................................:::........ ..... ......................:.....::.:............. Y;Yt : ...... .t..............................:...:. :::::::::::::::::::.�-:•::..•::-::::::::..::::::::::::.�::.:�::::::•. :::•i:•:::•••...:•.•:::.�:•:•iiii:v............. :>•isi sC:i:ii:•}ii:':•i;•};:ryi:•:ii:vi:•::..iiiiiii}::•;}i}ii?:4'•:�ii}i}iiiiii:G:i?4i'iivii:......::... :i::`^F:ii%:}i:i':v+: esnranee:co:;<::>:>:.::;.<::.... :..::.:::.......,.:,:::..::.::::..:.::.,.:,.::........... .. . . .. oL V11111111111111011101111111 as;natae: ;>:#>:::::>::;;;.:;:;:::>;::::.. . .. .:. : ...... ::: `on z' :h Cii: .vi:':i:<:••:;:•.:.:::;:•.:;:;:'.:':?:•':'i:•.::':•'':i�':};. ,i:,::i:;:•:':v.:::',:'ii:':is:is4: .'(:•:;:};-'':ii:-!„ :•:•:;:�+?:•i�:i:titii':':i•'., :::•'�•::':! :•:::.�.�::::::::::::::::::n� i:•:•isv i':•ii:4:•iii:i4:4:}Si•i ih0 i.iY.:{:i:•ii.....:L:': -iiTi:v!iJ:ii}};4:?:?i:}};•i::•:: :•: �p ry .:..:..� :: .:...:. ..:. ruti:ran'cri'coa'.:..... :r•; ::..:.:....:..::.>:.:::.:;:,.::..;,:....;:•. ......... .......•... ......... .. - .. j� Fanure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under the pains and penalties of pedury that the information provided above is true and correct. Signature Date /® 3 ' Print name �E"�� Phone# 7i- l official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Buffing Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Others_ Ucymd 9/95 PIA) s � T Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", 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 section 25 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,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. me Applicants X, Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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. The affidavits may be wt uned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 Imlesduadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 °pTME�°� Town of Barnstable - y`"P Regulatory Services M'FrAB \ 'auss Thomas F.Geiler,Director 9�P1 fD MAC a�°� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date : 6 AFFIDAVIT HOME IMPROVEMENT 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-occupied 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: le. s-X iZ• /' .� rBA�k Estimated Cost 16.51op® Address of Work: q rf S 'V <✓ad Gi/L Owner's Name: AZL,1/�R 4—=l Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law [fob Under$1,000 Building not owner-occupied 2f5wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME RYIPROVEMENT 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. Date wner's Name RESIDENTIAL: SHEDS -POOLS -DECKS-OPEN PORCHES- GAZEBOS FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft.(Sheds,gazebos,etc.) >120 sf-500 sf $35.00 $ >500 sf-750 sf 50.00 $ >750 sf- 1000 sf 75.00 $ >1000 sf- 1500 sf 100.00 $ >1500 sf—USE NEW BUILDING PERMIT APPLICATION DECKS / x$30.00= $ 6"0!� (Number) PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 $ ABOVE GROUND'SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) y PERMIT FEE $ Q:forms:dkcost eff:092301 I The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 13 (D JOB LOCATION: q �/ le A Alp number street I village "HOMEOWNER l�)l4 Ne.-a- C1 �2� Cs.0 name home phone# •work phone# CURRENT MAILING ADDRESS: c) city/tovjm 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 applicable.codes,bylaws,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 require nts. Signature of Homeo 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 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(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 of a Supervisor. On the last page of this issue is a application,that the homeowner certify that he/she understands the responsibilities ` � ` � �. �' l� v _ �- �^ � � _ oP �� ,, . 1 � \ � � _ . � - �- '1 '� � .`i �- 1 � �3 ` _ it •' °FINE ram, Town of Barnstable ti P Regulatory Services BAMNSTABv MASS.EE'�` Thomas F.Geiler,Director 1639. �AlFD MA'I aim Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, •' ` , as Owner of the subject property l - hereby authorize to act-on my behalf, in all matters relative t work authorized by this building permit plication for: (Address of J b) Signature of Owner Date Print Name Q:FORM&O WNERPERMLSSION I T�•Q F TY LI S MAY NOT OEACCUR TE STANDARD LEGEND ap 2 NOTE:not all symbols will appear on a map GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES o 6 3 " "' EDGE OF BRUSH ORCHARD OR NURSERY- Map 2/ 9-V-V•-9 EDGE OF CONIFEROUS TREES MARSH AREA EDGE OF WATER __-- -- DIRT ROAD . DRIVEWAY - E—PARKING LOT ..• ., .. ... `�^- I ��PAVED ROAD ---- -- DRAINAGE DITCH 2 3 ----- PATH/TRAIL PARCEL LINE 27 S, NJIP 110-r—MAP# \ 21 F—PARCEL NUMBER #1860 E HOUSE NUMBER \ / 2 FOOT CONTOUR LINE is 10 FOOT CONTOUR LINE / \ 0 8 Elevation based on NGVD29 4.9 SPOT ELEVATION / 670 \ / STONE WALL FENCE a 2/7 3 RETAINING WALL RAIL ROAD TRACK STONE JETTY 1 0 SWIMMING POOL y�1 PORCH/DECK Q 0 BUILDING/STRUCTURE o •••'• 273 •••••, � DOCK/PIER pQ HYDRANT .. Ma 2 3 Ma 2 73 e VALVE ® MANHOLE O POST pFP FLAG POLE - T O W N O F B A R N S T A B L E G E O G R A P H 1 G 1 N F O R M A T 1 O N S Y S T E M S U N 1 T a SIGN ® STORM DRAIN M PRINTED SaUE:IN FEET J*NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graLrep�resentation DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James 1"=100'scale map and may NOT meet of property boundaries.They are not trand W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE n TOWER 0 20 40 National Map Accuracy Standards at this do not represent actual relationships tocts Corporation. Planimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards enlarged scale. on the ma at a scale of 1"=100'. Parcel lines were digitized from FY2003 Town of Barnstable Assessors tax maps. O LIGHT POLE O ELECTRIC BOX s 1 INCH=40 FEET* g P� 9� P F-\dgn\conservation:dgn 05/30/03 10:26:46 AM