HomeMy WebLinkAbout0054 CEDAR STREET (12) �oia
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel' ® ` 6 Application #cxel®d
Health Division Date Issued
Conservation Division `.Application Fee
Planning Dept. `Permit Fee' 1: 1
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation/ Hyannis
Project Street.Address C r S�®
Village h 5
Owner eA KOLR Address T-1S v ADZS��
Telephone
Permit Request ev\ \/G1-�1 Ne�j ()2 D0 Ids er
V p 42 2G \r i C_ V vvn� b Co.
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Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation o't , Construction Type
Lot Size Grandfathered: D/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: YFull eddCrawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement UnfinishedArea (sq.ft)
Number of Baths: Full: existing_ new Half: existing new
Number of Bedrooms: 3 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 U�o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: dexisting ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing U new size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: o c
. o z
'Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ -i -n
cn u
,Commercial ❑Yes ❑ No If yes, site plan review#
Current Use &AV. Proposed Use 3
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Cfl r
APPLICANT INFORMATION m
(BUILDER OR HOMEOWNER)
Name T6V\,ke \ Kocq Telephone Number /74-�63 r 02H 1
Address + ` '�oX y License#
U he �V4 �elyeh 02�1- Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 08Ae_ .EY-P0C5
r
SIGNATURE DATE 1/30/10
! S '
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED ;,,. ,, La€
;MAP/PARCEL NO:,
x - -
-ADDRESS VILLAGE
OWNER-
, r _
,f
j DATE OF INSPECTION:
` 'FOUNDATION'-."r:¢" r }"
` FRAME
t
INSULATION<;i '_ #��'.
r FIREPLACE
,t ELECTRICAL: ROUGH FINAL
, x
` PLUMBING: ROUGH FINAL
ROUGH FINAL
a iFINAL BUILDING`,..
f
SE DATE_CLOSED.OUT
ASSOCIATION PLAN NO.
The Commonwealth of Massachusetts
y Department of Industrial Accidents
Office of Investigations
600 Washington Street
t�, f Boston, MA 02111
yy ww)-v,mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Lekibly
Name (Business/Organization/Individual):
Address:
City/State/Zip: V1VlV_ d�A d-ve_(n Phone #:
Are you an employer?•Chec the appropriate box: Type of project(required):
1,❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction
employees(fti11 and/or part-time).* have hired the sub-contractors_. _ .....- . .
2-❑ I am a sole proprietor-or partner-
listed on the attached sheet, 7. ❑ Remodeling
ship and have.no employees These sub-contractors have g, ❑ Demolition
working for me in any capacity. employees and have workers' 9 ❑ Building addition
" [No workers' comp. insurance comp, insurance.1
required.]
-
5. ❑ We are a corporation and its IO.❑ Electrical repairs or additions
3. I am a bomeowner•doing all work officers have exercised their 1 LE] Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.] t c.-152, §1(4), and we have no
employees. [No workers' 13.❑Other
R 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 arc doing all work and then hire outside contractors must submit a now 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
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 o f this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
Ldo hereby under t p n d enal 'e ofperjury that the information provided a ove ' true and correct.
Si nature; - l Date: /o
Phone# / / 50 l — l
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#:
P�0(KE ti Town of Barnstable
Regulatory Services
x gAABa13LE,
JABS. Thomas F. Geiler, Director .
b;E,ra,� Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.ba rnsta ble.ma.us
Office: 98-862-4038 Fax: 508-790-6230
---------------------
HOMEOWNER LICENSE EXEMPTION
q °O Please Print
DATE: 1
10B LOCATION: Ce r /
number 'y--r street village
"HOMEOWNER" �MIEL- OG� 72 9 -563- 02`1q
name home phone N work phone tl
CURRENT MAILNG ADDRESS:
r ve �2
city/to 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"homeown r c ifies that he/she understands the Town of Barnstable Building Department minimum inspection
proc u ,��aln.drnre�ire e t an tat he./she will comply with said procedures and requirements.
�G�
Signature of Homeowner
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 caret amend and
adopt such a form/certification for use in your community.
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC
Revised 072110
of THE Tay
■ BAHNSTABLE,
'MS Town of Barnstable
prFD MA'S a
.Regulatory Services
Thomas F. Geiler, Director
Building Division
Thomas Perry, CBO
Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us r
Office: 508-862-403 8 Fax.: 508-790-6230
Property Owner Must
Complete and Sign. This Section
If Using A'Builder
as Owner of the subject property
hereby authorize` to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Owner Date
Print Name
If Property Owner is applying for permit, please complete the Homeowners License Exemption Form on the
reverse side.
QAWPFILESIF0RMSlbuilding permit formsTXPRESS.doc
Revised 072110
�r
LE 5 t5 eEF
Monthly Rental Agreement
.......................................................................................I.................................... ................ ...............
THIS AGREEMENT, entered into this
"VA,w day of -12010 by and
between Km" hereinafter Lessor,
and hereinafter Lessee.
WITNESSETH:That for and in consideration of the payment of the rents and the performance of the co I venants
contained on the part of Lessee,s, W less does hereby demise and let unto Lessee,and Lessee hires from Lessor
)hose pre n ises described as* A e 14dreNN0 U 6e S 0
located at:
for a tenancy from month-to-month commencing on the day of
20 and at a monthly rental of Dollars
$�i 00.00 per month,payable monthly in advance on the
day of each and every month,on the following TERMS AND'CONDITIONS:
1. Form of Payment. Lessee agrees to payment each month in the form of one,person'al check, OR one cashier's
check,OR one money order made out1to
2.Delivery offtyment. Rent will,be paid:
'*Wby mail,to-T^w Kocl" 01 r vein 0:Z5
3.Returned Checks.if,for any reason,a check used by Lessee to pressor wi,
-Lessor is returned thout.having been paid,
Lessee will pay a'charge of I%A�O_Vz�v _Vivp Dollars
($ 7_5.00 as additional rent AND take whatever ether consequences there might be in
making a late payment.After.the second time a Lessee's check is returned, Lessee must thereafter secure a cashier's
check or money order for payment of rent.
4. Late PaymentsJor any rent payment not paid by the date due, Lessee shall pay a late fee in the amount of
Dollars,($-- 56.00
T_
5. Prorated First Month For the period from Lessee's move-in date, 20
through the'end of the month, Lessee will-pay to Lessor a prorated,monthly,rent of
Dollars($ This amount will be paid on or before the date the Lessee moves in.
6. Occupants.The said premises shall be occupied by no more than IVA adults and -AIA
children.
7. POts.Pets shall not be allowed without the prior pritten.'consent of the.,Lessor.At thetime."of signing
ning this lease, -
Lessee shall pay to Lessor, intrust,a deposit of NA Dollars
$ - Af'A , ),to be held and disbursed for pet damages to the Premises(if any)as
provided by law.This deposit is in addition to any other security deposit stated in this lease.Any Lessee who,wishes
to keep a pet in the rented unit must sign a Pet Agreement Addendum.
8. Parking.Any parking that may be provided is strictly self-park and is at owner's risk. Parking fees are for a
license to park only. No bailment or bailee custody is intended. Lessor is not responsible for,- nor'does Lessor assume
any liability for damages caused by fire, theft,casualty or any other cause whatsoever with respect to'any vehicle.or
its contents. Snow removal is the responsibility of the vehicle owner.Any tenant who wishes to rent a parking'space
or garage must sign a Parking Space or Garage Rental Agreement.
Page I of 4
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CA
9. Ordinances and Statutes. lessee shall comply with all statutes,ordinances and requirements of all municipal,
state and federal authorities now in force,or which may hereafter be in force,pertaining to the use of the premises.
10. Repairs or Alterations. Lessee shall be responsible for damages caused by his or her negligence and that
of his or her family or invitees and guests.Lessee shall not paint,paper or otherwise redecorate or make alterations
to the premises without the prior written consent of lessor.All alterations,additions,or improvements made to the
premises with the consent of Lessor shall become the.property.of Lessor and shall remain upon and be surrendered
with the premises.
11. Painting..Lessor reserves the right to determine when the dwelling will be painted unless there is any law to
the contrary.
12. Keys. Lessee will be given_key(s)to the premises and mailbox key(s). If all keys are
not returned to Lessor following termination of lease, Lessee shall be charged
Dollars
13. Locks. Lessee agrees not to change{ocks on any door.or mailbox without first obtaining Lessor's written
permission.Having obtained written•permission, Lessee agrees to pay for changing the locks and to with one duplicate key perlock. provide Lessor,
14. Upkeep Iof Premises Lessee shall keep'and maintain:the premises in a clean and sanitary
times,and upon the termination of the tenancy shall surrender the premises to lessor in as good condition as when
received,ordinary,wear,and damage by the elements excepted:
15. Assignment and Subletting.Lessee shall not assign this Agreement or sublet any portion of the premises
without prior written consent of Lessor.
16. Utilities. Lessee shall be-responsible for the'payment of.all utilities and services,except ;N..
which shall be pad by Lessor.
17. Default. If Lessee shall ail to pay rent when due, or perform any term hereof,after not less than three(3)days
written notice of such default'given in the manner required bylaw, Lessor,at his option,
all rts of
Lessee hereunder, unless Lessee,within said time,shall cure such default. If Lessee abandons'or terminate acat s the property,
while in default of the payment of rent;`Lessor may consider,any property left on the premises to be abandoned and
may dispose of the,,same in any manner allowed by law.
18. Security.The security deposit in the amount or TehOv�l d CCQ iS_ d S l 5
($_ — 0 — Dollars
),shall secure the performance of lessee's obligations hereunder. Lessor may,
but shall not be obligated to,apply all or portions of said deposit on account of Lessee's obligations hereunder.Any
balance remaining upon termination shall be returned,without interest, to Lessee.lessee shall not have the right to
apply the security deposit,in payment of the last month's rent.
19.Right of Entry Lessor reserves the right to enter the demi'sed'premises at all reasonable hours for the purpose
of inspection,and whenever necessary to make repairs and alterations to the demised premises. Lessee hereby
grants permission to Lessor to show the demised premises to prospective-purchaser's, mortgagees,tenants,or contractors at reasonable hours of the day. workmen,
20. Deposit Refunds.The balance of all deposits shall be refunded within two(2)weeks(21 days in California
and Wisconsin)from date possession is delivered to Lessor,together with a statement showing any charges made
against such deposits by Lessor.
.. Page 2 of 4
wwwwratescom
21.Termination.This Agreement and the tenancy.hereby`granted maybe terminated at any time by either party
hereto by giving to the other party not less than one full month's prior notice in writing.
22. In Lessor has obtained insurance to cover fire damage to the building itself and liability insurance to
cover certain personal injuries occurring as a result ofproperty defects or Lessor negligence.Lessor's insurance does
not cover Lessee's possessions or Lessee's negligence. Unless the opt-out clause below is initialed by both Lessee
and Lessor,Lessee must obtain a renter's insurance policy to cover damage or loss of personal possessions as well as
losses resulting from Lessee's negligence.
Opt-Out Clause: x .
Lessee and Lessor must both initial and date here if the requirement that Lessee obtain renter's
insurance is waived.if the requirement is waived, lessee will not be required to obtain renter's.
insurance.Lessor's insurance policy does not cover damages or loss of Lessee's personal
possessions as well as losses resulting from Lessee's negligence.
23.Attorney's Fees.The prevailing parry in an action brought for the recovery of rent or other moneys due onto
become due under this lease or by reason of a breach.of any covenant herein contained or for the recovery of the
possession of said premises,or to compel the performance of anything agreed to be done herein,or to recover for.
damages to said property,or to enjoin any act contrary to the provision hereof,shall be awarded all of the.costs in
connection therewith,including, but not by way of limitation,reasonable attorneys'fees:.
24. Rules and Regulations. Lessor's existing rules and regulations, if any,shall be signed by Lessee,attached to
this agreement and incorporated into it.Lessor may adopt other rules and regulations at a later time provided that
they have a legitimate purpose, not modify Lessee's rights substantially and not become effective without notice of
at least two(2)weeks.
25. Radon Gas Disclosure'.As required bylaw',(Landlord)(Seller)makes the following disclosure:"Radon Gas is
a naturally occurring radioactive gas that,when it has accumulated in a building in sufficient quantities,may present
health risks to persons who are exposed to it overtime.Levels of radon that exceed federal and state guidelines have been
found in buildings in every state.Additional,information regarding radon and radon testing may be obtained from your;
county public health unit."
26. Lead Paint Disclosure. "Housing built before 1978 may contain lead-based paint. Lead from paint,paint
chips,and dust can pose health hazards if not managed properly.Lead exposure is especially harmful to young
children and pregnant women. Before renting pre-1978 housing,lessors must disclose the presence of known
lead-based paint and/or lead-based paint hazards in the dwelling. lessees must also receive a federally approved.
pamphlet on lead poisoning prevention."
x 27.Additional Terms and,Conditions. Gorr% hli}� ow rvs`
The. Les e. dckh e uc��
- Cr . c e •�.�c wi� w i
d or dh M ncc% w .
►� r e
t e _V r' r ou rr�►�d�`e
o 0 I C G e �Cd or- S S
ht
o eY^ VE her
Tie es t e ces 't.5 -� or e D
wwwmaates.cam , Page 3 of 4
IN WITNESS WHEREOF, the parties hereto have executed this Agreement in duplicate the day and year first
written above.
Signed in the presence of:
Witness Lessee
Witness Lessor
NOTICE: State law establishes rights and obligations for parties to rental agreements.This agreement is required to
comply with the Truth in Renting Act or the applicable Landlord Tenant Statute or code of your state. If you have a
question about the interpretation of legality of a provision of this agreement,you may want to seek assistance from
a lawyer or other qualified person:
Page 4 of 4 , .
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