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HomeMy WebLinkAbout0229 COMPASS CIRCLE aa� ��. f - --- _ _ - ------� �� �1 � . Town of Barnstable *Permit � Expires 6 months from issue date Regulatory Services Fee a swxwsrest E Thomas F.Geiler,Director tKns.�. Building Division .orFD Mp`l Tom Perry,CBO, Building Commissioner 200 Maui Street,Hyannis,MA 02601 www.town.barnstable.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 0 C� Property Address � J �b✓t" :Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name-A /V(a9/y Mew C� Teleph one Number Home Improvement Contractor License#(if applicable) (v l 3 PERMIT ❑Workman s Compensation Insurance Check one: MAY 3 0 2008 ❑ I am a sole proprietor ❑ I am the Homeowner INr I have Worker's Compensation Insurance TOW of �A��STA�LE . Insurance Company Name /U 14/ M Workman's Comp.Policy Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value V (maximum *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required.- SIGNATURE: QAWPFILESTORMS\building permit forms\EXPRESS.doc Revise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street . Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information J , . {. Please Print Le 'bl Name(Business/Organization/Individual): A C e 0 ""/ S eX ACC,C—S Address: City/State/Zip: ICn 3��3� Phone.#: K 7 .S) a Are you an employer? Check f e appropriate box.: Type of project(required): 1. I am a employer with 4. E I am a general contractor and I 6. ❑New construction have hired the sub-contractors employees(full and/or perrt-time).* 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling These sub-contractors have g, �]Demolition ship and have no employees working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp.•insurance �mP insurance.$ required.] 5. We are a corporation and its 10.E Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers comp_ ' / t C right of exemption per MGL 12.E Roof repairs insurance required]t c. 152, §1(4),and we have no 13 iK Other "V `n dC j employees. [No workers' comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workca'compansation 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. 4--ontractors that check this box must attached an additional sheet showing the name of the sub-conhacton and state whether or not thosd entities have employ—. if the sub-contractors have errrployces,they must pravidb their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the polity and job,site information. n Insurance Company Name: !U/ Policy#or Self-ins.Lie.#: ?S S Expiration Date: / lob Site Address: City/State/Zip: 4 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to scctae coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a fine tip 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 InVCSti atiMS of the DIA for insurance coverer a verification. ----------------- I do hereby serfs;fy under the pains•and penalties of perjury that the information provided above is true and correct Signature: " YL �c. �,n Date: Phone# 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 Cnntact Person: Phone#: 4• _a 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(7)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 certificates)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 nur4ber listed below. Self insured companies should enter their self-insurance license number on the appropriate line. _— City or Towp 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/licensc 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 obt daing a license or permit not related to any business or commercial venture (i.e. a dog license or permit to born 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 Massachus dts Dq rfinent of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 TO. #617-727-440.0 ext 4.06 ar 1-977-MASSAFE Fax# f 17-727-7749 Revised 11-22-06 www.mass.gov/dia �FTHE-t Town of Barnstable Regulatory Services f � MASS. q Thomas F. Geiler,Director �p i63q.. �� r�16.39 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 and Sign This Section If Using A Builder Ja✓l `�S , as Owner of the subject property hereby authorize/�I_ �}�}�1�All�%� lkM JbL"d� to act on my behalf, in all matters relative to work authorized by this building permit application for: 6'c (Address of Job) *Avl3 a Signature of Owner Date Print Name If.Property Owner is applying for permit please complete the Homeowners License Exemption.Form on the reverse side. Town of Barnstable mop THt3 rq�� • Regulatory Services • sarzrrsTwBt.E, Thomas F. Geiler,Director MASS. �m� Building Division PIEDrA Tom Perry,Building Commissioner . 200 Main Street, Hyannis, MA 02601 wmy.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 _____----,----- HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state rip 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 requirements. 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 i o9.1.1-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, e results in serious problems,particularly ' ensin Construction Supervisors,Section 2.15) This lack of awareness often p ,p Rules&Re lations for lac g p ! . 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. MAY-24-2008 05:05AM FROM- T-712 P.006/006 F-463 HOME IMPROVEMENT CONTRACT Sold,Furnished and installed by: 2(� TITD At-Home Services,Inc. Branch Name: L7d 1S Date: S-Z3 0$ d/b/a The Home Depot At-Home Services 345A Greenwood Street,Worcester,MA 01607 Branch Number: 'J� Job#: � Toll Free(800)657-5182; Fax:508-756-2859 Federal ID#75-2698460 ME t-ic 4 C 02439 RI Com Lic#16427 CT Lic#565522; MA Homc improvement Contractor Reg.#I26893 Installation Address: Sac\ C<>yn 5 5 C,FcZ e— S rn CD—)-(001 C State Zip Last 4 Digits of Driver's Purchaser(s): Lie.#&Exp.Ivlo/Yr: Work Pbonc: Home Phone: . )� . g a ( 0 '7 qo ):Tome Address: (If different from Installation Address) City State Zip E-mail Address(to receive updates and promotions from Thu Home Depot); Project Information: T/We/You("Purchaser"),the owners of the property located at the above installation address,offer to contract with TI-ID At-Home Services,Toe.("Home Depot")to furnish,deliver and arrange for the installation of all materials as described on the attached Spec Sheet# 1 O to O ,incorporated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if,upon re-inspection of the job,Home Depot determines that it cannot perform its obligations due to a structural problem with the home,pricing errors or because work required to complete the job was not included in the Spec Sheet or Contract. DEPOSIT PAYMENT OPTIONS (Subject to fund verification and/or credit approval.) CONTRACT AMOUNT $� o� 1. Check*,Cashiers Check or US Postal Service Money Order (Made payable io The Home Depot). tLESS DEPOSIT 2, Credit Curd**and/or other payment options-Circle One Below BALANCE DUE Visa Mas-ttaCurd D&aver Amcri cs ON COMPLETION s z The Home Depot IIommo Improvement Loan The]dome Depot Gcd t Car tMinimum 25%u of Contract Amount due upon Q New Account t]Existing Account (HiL&HDCC ONLY) execution of this contract. Available Credit:S (11M&HOCC ONLY) Indicate Payment Method For Accig;(CQ35-5ZOOB095'1`6`_16Exp.Dam: BALANCE DUE ON COMPLETION: K Name as it appearson card: t\R k **)3y my/our signature below,I/We agree to allow Home Depot to 1 t charge the above referenced credit card for the deposit indicated. *When you provide a check as payment,you authorize us either Or to use information from your check to make a one-time electronic Cardholder's Sigaamre Dnte fund transfer from your account or to process the payment as a check transucuon.When we use information from your check to HIL or HDCC Authorization Codes make an electronic fund transfer,funds may be withdrawn from your account as soon as the payment is received,and you will not Deposit Final Payment receive your check buck L # # Purchaser agrees that,immediately upon completion of the work,Purchaser will execute a Completion Certificate and pay any balance due. Purchaser also agrees to be jointly and severally obligated and liable hereunder. Entire Agreement-This agreement and its attachments,including any financing agreement,contain the complete agreement between the parties and can not be amended or modified unless in writing in a separate agreement signed by both parties. NOTICE TO PURCIiASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep it to protect your rights. Do not sign a Completion Certificate before this project is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to be performed under the contract. You may cancel this transaction any time prior to midnight of the third business day after the date of this contract. See Notice of Cancellation for an explanation of this right. There will be a service charge equal to 10%of the contract amount if job is cancelled by Purchaser AFTER the third business day,but BEFORE materials are ordered.There will be a service charge equal to 25%of the contract amount if job is cancelled by Purchaser AFTER materials are ordered. BY MY/OUR SIGNATURE BELOW,I/WE UNDERSTAND THAT THE AGREEMENT MAY BE SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND I/WE AUTHORIZE HOME DEPOT TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEPENDENT CREDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY INCURRED FROM INADVERTENT OMISSIONS OR ERRORS. BY MY/OUR SIGNATURE BELOW, WE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT, UWE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. SUBMITTED BY- Date: 5-Z3-G.K _ el ultoat ACCEPTED BY: Date: Purchaser Date: Purchaser NOTICE:ADDITIONAL TERMS AND CONDITIONS ARE STATED ON TTTE REVERSE SIDE AND ARE PART OF THIS CONTRACT 9-21-07 rev4-2-07 C-SC White—Branch File Yellow—Customer Pink—Sales Consultant WINDO W SPECIFICATION SHEET - spec.stieet#:W 10 0 0 3 3 Sheet: I of , r Dater Job#: ?&Q(362 Consultant: Customer: , lFidsting Window NewWlndow Measurements Grids Pattern' Pattern' ' Pattem'.2 Window Hinge l_ocatlons' c a Glass Misc. Cam1,CPC,Boy Bow, Rough Opening o o lients a I � Options Patro a oereer,oaare Location style Meta Style Series n _ °Code" ram" {rmrn ouurde,Lt to Ail I Width Height Ui N t {RaornJFloar) "Code" YN "Code" "Code U D ry GAR �1,00 wN -51 3Ll la`s 5cr 2 - 3 5 6 7 s •, It S2 Grid Pattern and Location MUSY be indicated. Color oT W I S e if a single window or mulled windovrs require mullip.e grid patlerns,indicalelocalion and pattern in line additional spaces presided. ihlndovr!Door Maps 1 arCsmts,CPC,Bayor Bakv,use'C,"R",ar"S'(Stationary).For Patio&Garden Doors,use'S"(Stationary)or"X"(Operating). BAY!13OW WINDOW GARDEN W INDOW s Projection Angle:(Bay:30'or 45°) Top of Window to Salfit{inches} WAt_LTHICKNESS' {inches} �S Bay Window Flankers-DH 1 Csm[. Width of Gverhang{inches) _ SEATBOARD MATERIAL Seathoard Material Birch arOalcAWO it tied to Soffit,cater of Soffit material Specify Birch orOak Veneer or White Pionile 1�-Q1w.) New Interior Casino lBavlBowtGarderdPatio Coors), Construct Roof(Yes r No) 'Addlional charge for wall thickness of Far more. LL Ctamshelf(Ct)or Colon[21(CO) 3 Thera is no guarantee that new shingles mill march existing color_ ` I have reviewed and agree with all of the I SPECIAL CONSIDERATIONS: N© nRtQS-k job specifications described above. 0 0 N r - �Obs1crner5icna[ure e v N -c 5-1-00 SFC M AC®R®r. CERTIFICATE ®F LIABILIT"Y INSU1�ANCE D2/26 /08YYYY, 02/26/08 PRODUCER 1-404-995-3000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR homedepot.certrequest@marsh.com ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3475 Piedmont Rd NE, Suite 1200 Atlanta, GA 30305 Fax (212) 948-0902 INSURERS AFFORDING COVERAGE NAIC# _ INSURED Home Depot U.S.A., Inc. INSURERA:Steadfast Ins Co 26387 The Home Depot, Inc. INSURERB:Zurich American Ins Co 16535 2455 Paces Ferry Road Building C-8 INSURER C:Illinois Natl Ins Cb 23817 Atlanta, GA 30339 INSURER D:American Home Assur Co 119380 INSURERE:New Hampshire Ins Co 23841 COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION - LTR NSRD TYPEOFINSURANCE POLICYNUMBER DATE MMDD Y DATE MMIDDYY LIMITS A GENERAL LIABILITY IPR 3757 608-02 03/01/08 63/01/09 EACH OCCURRENCE $4,000,000 X COMMERCIAL GENERAL LIABILITY LIMITS OF POLICY ARE EXCESS MAGETORENTED PREMISES(Ea occurence $1,000,000 CLAIMS MADE OCCUR "OF SIR: $1,000,000 PER CC" MED EXP(Any one person) $EXCLUDED PERSONALBADVINJURY $4,000,000 GENERALAGGREGATE $4,000,000 . GEN'L AGGREGATE LIMIT APPLIES PER: _- , PRODUCTS-COMP/OPAGG s4,000,000 X POLICY PRO- JECT IOC B AUTOMOBILE LIABILITY BAP 2938863-05 03/01/08 03/01/09 X COMBINED SINGLE LIMIT $1,000,000 ANY AUTO (Ea accident) ALLOWNEDAUTOS BODILY INJURY $ SCHEDULEDAUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNEDAUTOS _ (Per accident) X SELF INSURED AUTO PROPERTYDAMAGE $ PHYSICAL DAMAGE (Per accident) GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $- ANYAUTO - _ - OTHERTHAN EAACC $ AUTO ONLY: I AGG $ - A EXCESSIUMBRELLA LIABILITY IPR 3757 608-02 03/01/08 03/01/09 EACH OCCURRENCE $5,000,000 X OCCUR CLAIMS MADE AGGREGATE $5,000,000 $ DEDUCTIBLE RETENTION $ $ C WORKERS COMPENSATION AND 1928757 (FL) 03/01/08 03/01/09 X ORYLAITS OTH- .D EMPLOYERS'LIABILITY ER 1928756 (CA) ANY PROPRIETORIPARTNER/EXECUTIVE 03/01/08 03/01/09 E.L.EACH ACCIDENT $1,000,000 E. OFFICER/MEMBER EXCLUDED? - 1928755(AOS) 03/01/08 03/01/09 E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE•POLICY LIMIT $1,000,000 OTHER F TX Employers Excess TNS-C45197967 (TX) 03/01/08 03/01/09 Occurrence/SIR 25M/2M D Workers Compensation 1928759 (QSI) 03/01/08 03/01/09 E Workers Compensation 11928758 (KY, MO, NY, WI) 03/01/08 1 03/01/09 DESCRIPTION OF OPERATIONS LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *FOR EVIDENCE ONLY CERTIFICATE HOLDER CANCELLATION ' - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THE HOME DEPOT, INC. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 2455 PACES FERRY RD., N.W. BUILDING C-8 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. ATLANTA, GA 30339 AUTHORIZED REPRESENTATIVE USA ACORD 25(2001/08)datkinson ©ACORD CORPORATION 1988 8213215 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR } Registration _126893, E p�ration 813/2008 j ement Su' l Card r . 9 VIA,- Home Seruic THE Home Dep ofa, IWARK NIADA by�2 3200 COBB GALL EFtA 0 HtIANTA,GA 30339. Administrator-- T7 TOWN OF BARNSTABLE I BUILDING PERMIT j I PARCEL ID 310 427 GEOBASE ID 22970 ADDRESS 229 COMPASS CIRCLE- PHONE HYANNIS ZIP - ILOT 41-A BLOCK LOT SIZE DBA DEVELOPMENT. DISTRICT HY PERMIT 36557 DESCRIPTION 16'X 30' DECK PERMIT TYPE BADDD TITLE BUILDING PERMIT ADD DECK CONTRACTORS: PROPERTY OWNER Department of Health, Safety ARCHITECTS: and Environmental Services � BOND� TOTAL FEES: �2$..00 00 OkTHE iCONSTRUCTIOSTS $1,800.00 434 RESID ADD/ALT/CONY 1 PRIVATE PMHAMSrABM #' E�r MASS. �► 039. �♦� BUILD N BY DATE ISSUED 05/19/1909 EXPIRATION DATE ' ry yf„.„'`" a ,'w. ` >•• .a,. W OF GF3't.[itq-��fg7��1.�1.51Ga1l E n IT PARCEL ID 310 A,2.11 r GEOBAM, III -22970 � A3 DRESS;-.. 22.5 'COMPASS CIRCLE � � � � PyykTipONE 'LOT . 41 BLOC LOZ SIZE SBA ; ODE tELt3I'M N' DISTRICT HY Ii I'' FLy$I{ R y P, 1 ON*1 6.;. p X ,30. ' DECK "':; r•r ` '�'f 'Y PERMIT TYPE BAD5 —,. TITLV,-a: ���G:ILI�INC PERMIT ADD DECk f 1 COTR PROP FIt' OWNER : . °w Department of Health, Safety and Environmental Services TOTAL. FEES: �,. �"�-"t�„.w � � �2a _0 F+uOISTRt]CTI4STS I,800 0 ? . e., k I -. "'�+'.�`-: . '}D/Y1 ytiT j`4i�.+l.V J 'N 1 PRI V A`i E .T' AB L �� LE r * MAM s639.. •� 1 .BUILDING DIVISION I' . BY, DATE ISSUED 05/19/1993 EXPIRATION DATE ;I THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET-ALLEY°OR-SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR-PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER',THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF,PUBLIC SEWERS MAY BE OBTAINED FROMTHE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS, PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE;SUBDIVISION RESTRICTIONS.• MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST'BE RETAINED ON`JOB AND WHERE'APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF.00CU- PERMITS ARE REQUIRED FOR (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY:: , i s> n BUILDING INSPECTION APPROVALS, PLUMBING INSPECTION APPROVALS ; ELECTRICAL INSPECTION APPROVALS 2 2 2 i 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: ?. SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. I f I V f I! I I I V � l I it i I I I I I FTME, Town of Barnstable Regulatory Services ' BAR" Thomas F. Geiler,Director y MASS. $ �AtE1639. &,� Building Division Peter F.DiMatteo,Building Commissioner n 367 Main Street, Hyannis,MA 02601 �,1/�I q Office: 508-862-4038 Fax: 508-790-6230 SHED REGISTRATION 120 square feet or less r S Location of shed(ad ess) Village (Sa`l Property owner's name Telephone number 3 1 o L+ H1,, Size of Shed Map/Parcel# Signature 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. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg t` CRr;9Y CERTIFY T:I'.T T}115 cOUNDATION ZONING Rt.Gl.11 F,'1 t:i"!:i a. . ':!ii1U SRTHAC:KS ' r d CU/, xi w 0 C c9a•o o G� l I s d TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION /Map .0 0 Parcel Permit# n /Health Division � Date Issuedit /onservation Di 'sion L / Fee Ob Tax Collector' SEPTIC SYSTEM FAUST BE // INSTALLED IN COMPLIANCE WITH TITLE$ PlaVin �De t. ENVIRONMENTAL CODE AND Datni ve P nA by PI ninTOWN REGULATIONS His0 Preservation/Hyan ' Project Street Address Via" 9 Village - Owner (' Address u sS Telephone Permit RequestP��.1L Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost J R�0. Zoning District Flood Plain Groundwater Overlay 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 o Historic House: ❑Yes -' IrNo On Old King's Highway: ❑Yes AXNo Basement Type: WFull ❑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 NJ No'' • Fireplaces: Existing New Existing wood/coal stove: ❑Yes �ffNo 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 / BUILDER INFORMATION ✓Name Telephone Number Address License# -,Home Improvement Contractor# Worker's Compensation# , ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _ f _ v c - FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED = MAP/PARCEL NO. i r t ` ADDRESS r SVILLAGE OWNER r DATE OF INSPECTIQN: FOUNDATION ; FRAME i ,Ire• P INSULATION• 1 ��;" b - _ • , t• _ . FIREPLACE + ` ELECTRICAL: ROUGH_ 1t! FINAL - PLUMBING: ROUGLIi iri- ~a FINAL _ GAS: ROUGH'S r FINAL FINAL BUILDING _ �- �.- ! • - I~ --i = - - mn � w C� 17 - DATE CLOSED OUT Q rn 1.Z ASSOCIATION,PLAN Nd.ts1 _ t I_I,ERrpY CCRTIfY TI I I-T TifIS POtINIDATiON b ..;,C: i L OT ,, SHOWN Ahll7 ZG{Yfi.'G RiGUTAls.r4ki SFTHACKS Ft�[j11 9TiiEtl ..It1Eb AND 113t iANES. it Ff 717 h C BG•GO _ _—___ I oO B ERII ETT S. HODGKINS X1 CUSTOM BUILDING AND REMODELING P.O. Box 611 Centerville, MA 02632 (508)-778-7570 e � i O - — OiA I � n � ® n 41 1 a7 �• � 0..E ``� IT � $ .� -i `� vl� I a r SEIMNEW S. HODGKONS CUSTOM BUILDING AND REMODELING P.O. Box 611 Centerville, MA 02632 r (508)-778-7570 o 71 v c BENNETT S. HODGKINS CUSTOM BUILDING AND REMODELING VN_ P.O. Box 611 -� Centerville, MA 02632 (508)-778-7570 �7_. . - 1 �_ C, - , 10 1 " > N Y i a e v J BENNETT S. HODGKINS CUSTOM BUILDING AND REMODELING P.O. Box 611 Centerville, MA 02632 (508)-778-7570 (DIDto —{I -- � aAPNBrASI� � Department of Health Safety and Environmental Services Fo ' Building Division 367 Main Street,Hyannis MA 02601 ffice: 508-862-4038 Ralph Crossen axe 508-790-6230 Building'Commissioner Permit no. Date 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-ekisting 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: / X D Estimated Cost f—_ Address of Work: 2A, aim (2�4 Owner's Name: Date of Application: el- I hereby certify that: r Registration is not required for the following reason(s): El Work excluded by law Job Under$1,000 Building not owner-occupied er pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME 1UROVEMENT 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 LAX zzq -d S Date wner's Name q:forms:Affidav --_- - The Commonwealth of Massachusetts Department of Industrial Accidents lid _ ==I A Office 911Mesti90917s 600 Washington Street Boston Mass. 02111 Workers' CoT on Insurance Affidavit t/ nee: n location: �q u o /�>° city - hone# U� I am omeowner performing all work myself. I am a sole pro rietor and have no one workin in any ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. compnnv name address: city phone#: insurance co. P01icV# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the folloi•ing workers' compensation polices: companv name: address: dtv phone#- msornnce ca. oitcv#.. :.:•::.:;:.;:::;::.:.;.... camnanv name: "` .. address: city- ...... nhope#c Insurance co. :. .:::;:.;:;• ... oiiev# :<:> :.;:<>:>:<;.:: ::>;.>. � Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a flue up to S1.500.00 and/or one years'imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. I do hereby certify u deFthe pains and penalties of perjury that the information provided above is true and correct Sigtature Print name Phone# otIlcial use only do not write in this area to be completed by city or town official city or town: permitillcense# ❑Building Department (JLicensing Board ❑check if immediate response is required ❑Selectmen's Ofnce ❑Health Department contact person: phone#; ❑Other (revow 9l95 F1A) The Town of Barnstable E 'c Department of Health Safety and Environmental Services Building Division IL MSTM ' ' 367 Main Street,Hyannis MA 02601 MASS. �ATED M0'I� Office: 508-862-4038 Ralph Crosse Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print � l DATE: Iq / SOB LOCATION: ��- CA a lopa� (�I U '� P �L J�n(S `/��[��1. number street village "HOMEOWNER": 'I 3a,,-t S '7 Id` I Sa � name home phone# work phone# CURRENT MAILING ADDRESS: city/town 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 buildine 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 requireme ts. C 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 care to amend and adopt such a form/certification for use in your community. QTORMS:EXEMPT • t � i � o 0 0 a O ui s � C 1) sL _ '` 4 7' _L .__G"_w,d�? _ _ A rt � ' 1679 IAI W U A N L d 4ORir1AIi .� 12J75 ti0 jR,4 4 v �I TOWN OF BARNSTABLE Permit No. -_22142 1 sua..a a Building Inspector.. °: Cash _.-- °""Y� : OCCUPANCY .PERMIT- Bond •'�zal9 "No building nor structure shall be erected, and no-land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until'a certificate of occupancy has been issued by the Building Inspector." Issued to Cedar Acres Reality Trust Address *Sotf'th Yarmmth lot #4IA. 229 Compass Circle, Hyami.s Wiring Inspector f .s Inspection date�'" if,�`f _- Plumbing Easpector f J Inspection dateIle, Gas Inspector �A 'A Inspection date `Engineering Department ��� � � + Inspection date THIS PERMIT WILL NOT BE VALID; AND THE BUILDING SHALL NOT BE; OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. »..»........ 19?! ...............».».. l ( f " .l�.r� Building" »Inspector � f �jlz As$essor's rnop and lot number ............................................ . I E p — / •- PLO Sewage Permit number ....... '....... L.S�.........................: e Y Z BAMSTAMLE, i HOUSQ number .......... �� ...... GO rb e . ................ ................. 39• �0 �D Mix a' TOWN OF BA1� N.STABLE 'BUILDING ' . I ,SPtCTOR APPLICATION FOR- PERMIT TO .: ��9r�•.....:......:......:.............:............................................:......:.. TYPE OF CONSTRUCTION ..•.... ......................................... .... ................................ , ... .............19........ � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accordin to the following information: Location ... 7. .......�� r7 � ........ ...:......:....................:...........:.....:.:... ProposedUse <.......................................................................: - ZoningDistrict .. ... ...............................................................Fire District ........ . ... ... 6�............................................. Name of Owner .....: .z... � .............Address .C.. . /......... ............ Name of Builders .............................................Address ........ . • Name of Architect .......................Address ............: . ' Number of Rooms ..................................................................Foundation ....4. -T12. lfnC.............................................. Exterior ............Roofing ....... ......... Floors ! C. ......... �+....�'��. ...................................Interior ........I . . ..... `..�.................................... Heating ......................................:.............................Plumbing .:..:..... � Fireplace ..:.... ... ...........................................................Approximate Cost .............l:a � . Definitive Plan Approved by Planning Board ------_------_------------------19______:_.` Area Diagram of Lot and Building with Dimensions Fee S� .........� :' ".................. SUBJECT TO APPROVAL .OF BOARD OF HEALTH bD IN l 35 -Ys I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam < ...... ......... ... ... . .. ................................... � • : � -Cedar Acres Realty Trust., A=310-427 4 , r �`Jo ... ... Permit for ....Build-single...... axn��y...dw�a.J.zng.................................... Location .....Lot..4.1.A..Compass...Ci=1e.......... - " ....................I3yannis........................................... Owner ...Cedar...Acres..Real.ty...Trust.......... Type of Construction YP ...Wood••FramE................. .......................................... .................................. 1 Plot ............................. Lot !U.A......................... March 30 Permi-Granted ........................................1979 Date of Inspection ...... ..........................19 ` Date Completed . .............. ..........19 , PERMIT REFUSED ..................................... ...'.................. 19 ; .. .................................... ................................ ................................ ............ ..... ............................................................................... }} • .. ............................................................................... Approved ................................................ 19 ............................................ ................................... t . r .................... ......................................................... a Assessor's map and lot number ....................................... . OF THE TO Sewage Permit number ....... f'............................................. Z BAHB9TADLE, i House number .........�� ....�.-r'`............................................. 900 M679 \0� 0 OR a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... `......................................................................................... TYPE OF CONSTRUCTION f ................................................ ........................................ ...................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �r � - Proposed Use :fC' ...•!�.. "e, .. ..... ............................................................................................. Zoning District ....:f� .............................Fire District .......... yG . r..: ............................................ Name of Owner � �'� �` �' Address / -, :���+ °' -f� Nameof Builder .... ............................................Address ........< ................................................................. Name of Architect /11G.� .....................................Address .................................................................................... ........................... Number of Rooms .........6.....................................................Foundation ....`.... '.e?_:+_ . ................................................ Exterior ... ?....:C^......................................................................Roofing ....... *` :f�+................. t 1�.ir. Floors .................( Q.....`+.,t o n. �� ...................Interior ........ �!(. .0 �c_ r.. ............................ .......... ...... .................................. Heating ................................Plumbing nIM 4, Fireplace ...........................................................Approximate Cost . Definitive Plan Approved by Planning Board ________________________- ---____19______--. Area Diagram of Lot and Building with Dimensions Feed/.......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH J _ I I 13� , I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �,� Name .........................., ,..0 C L................................... Cedar Acres realty Trust =310-427 i, No 21142 Permit for .Build sing]e........ ......... amily...dwelling..................................... Location .................'�CompasS... 7.KCl�............. .................HY.ann ...... ................................ Owner Cedar„Acres R8 �:`;by,,,ZY]�St,,,,,,,,,,,,, Type of Construction ..W.O.1F' a dd... me.................. to . Plot ........................ ... Lot .......4 1.A..... ............ Permit Granted ...March 30 1 q 79 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED .......................................... 19 ...... .. . ............................ ...................... . .................................................. Approved ................................................ 19 ............................................................................... ...............................................................................