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HomeMy WebLinkAbout0029 CUMNER STREET �0�9 CrJM N i2 Smzc-E-r Town of Barnstable Building •. Post�ThisrCard;So That�t is�U�sible.From the.Street,�sA roued:Plans.,Must b'e�Reta'inetl on Job and�this Card Mustbe Kept � <� ;}• pp 8A1Vv"SCAriL6, Permit , 7 Arm ° Wher.'e asCertificate��of`O.ccu anc, s.Re u�red,such�Bwidm -shall Notbe�Occwp�ed unttl a Final Inspectionhas,been made f� ,�: .. Permit No. B-18-3820 Applicant Name: HYNES,CARL D& LISA S TRS A C pprovals Date Issued: 12/06/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 06/06/2019 Foundation: Residential Map/Lot: +306-133 Zoning District: RB Sheathing: Location: 29 CUMNER STREET HYANNIS Contractor Narne .:4.x Framing: 1 Owner on Record: Andy,Gary,Tina _ " Contractor License' s 2 Address: 9 Camelia Avenue „ Est Project Cost: $ 13,000.00 Chimney: Concord,NH 03301 x Permit Fee: $ 116:30 Description: Bathroom renovation-adding wall in second floor.bathroom to i Fee Paid $ 116.30 Insulation: make(2) Bathrooms,Adding Shower and toilet to new bathroom as j Date 12/6/2018 Final: wall as updating vanity,Fixtures and flooring Project Review Req: - �, ; „ •..�r�l Plumbing/Gas 5 Rough Plumbing: Building Official <- Final Plumbing: r `r Rough Gas: Final Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six�months after issuance. All work authorized by this permit shall conform to the approved application and tt a approved construction document0or whickilhis permit has been granted. Electrical All construction,alterations and changes of use of any building and structures shall be in compl ance with the localzonmgby laws and codes. This permit shall be displayed in a location clearly visible from access street or road andkshalPbe maintained open fb—r�publiqljnspiktion for the entire duration of the Service: work until the completion of the same. x x Rough: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: _ Final: 1.Foundation or Footing 2.Sheathing Inspection Low Voltage Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Health 7.Final Inspection before Occupancy Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Fire Department Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting ithunre ' ered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). "f ►, ApplicadonN=bea................ ......................................... BUM BAWMA Mr, Fee..........:..:.:. J ...00=Fee................... s639. NOV1 201 Total Fee Paid,.................................................................... I T � 1� O TOWN OF BARNST�tkF SARNS �,&by.. �...........on......... ....... ... BUILDINO-PERMIT . �.!(l. .per..Mv. .................. ......................................... APPLICATION Section I—Owner's Information and Project Location verge IA\ Auk) k) 1 Project Address �"1 ,( )rn j� S` 1` T �. - ^ Owners Name -G + Owners Legal Address Cer �►-�� % ,� City C p n C-0 eel State zip Owners Cell#(G263) ZAC-1 1 — -7 (o G_ E-man 0300 ICv M Section 2—Use of Stractare Use Group L ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial'Structure under 35,000 cubic feet M Single/Two Family Dwelling Section 3—Type of Permit •❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck. Apartment ❑ Sprinkler System.. ❑ Addition ❑ Retaining wall ❑ Solar YRenovation ❑ Pool ❑ Emulation Other—Specify Section 4 -Work Description 'ZATk b M e_ oc� R o �\nn co e_n c�0� 4--031 [9-I- -�,c� �P w R a a 1N� e T act nrn3;ded:nJM19 F L Application Number.................................................... F � i Section 5—Detail Cost of Proposed Construction G o O Square Footage of Project 1 �� Age of Structure 60 Y eA y(S CP ►0 Dig Safe Number # Of Bedrooms Existing C Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM ChecklistElDesign Section 6—Project Specifics VVin ❑ Oil Tank Storage ❑ Smoke Detectors lambing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply YPublic ❑ Private SewageDisposal ' 1 Munici al ❑ On Site � P Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: )P+9,O rO)M— wf6l'E I am using a crane ❑ Yes No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard ' Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last undated-2/9/2018 Application Number........................................... Section 9—.Construction Supervisor Name Telephone Number Address City .State Tap License Number License Type Expiration Date Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Construction`Supervisor in accordance with 780 CMR the Massachusetts State Budding Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section.10—Home Improvement Contractor Name Telephone Number Address City State Tap Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your EUC... Signature Date Section 11—Home Owners License Exemption Home Owners Name: CC-A izy �, A,gy W Telephone Number 60 3 i l 766 3 Cell or WorkNumber 603 'R) 7663 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachus Building Code. I understand the construction inspection procedures,specific inspections and documentation 0 CMRaridd the wn of Barnstable. Signature Date 11 I � ' PLICANT SIGNATURE Signature Date ) Print Name CAP. Telephone Number 0 y N E-mail permit to: Gr3_ 300 ® , r e•a....t..a. mnn'l 0 Section 12 —Department Sign-Offs Health Department © Zoning Board(if required) ❑ I Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ eP � Conservation ❑ For commercial work,please take your plans directly to the fire depadmentfor approval Section 13—Owner's Authorization 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 application for: (Address of j ob) f Signature of Owner date i Print Name - i 1 i Last 2/9r2018 �i ALIOP The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizationdndividual): &Ce �wbNe Address: City/State/Zip: g3 to A 2(a O 1 Phone#: (o d 3 L{ql 76 6 3 Are you an employer?Ch ck the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a'general contractor and I - employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- ..listed on the attached sheet. 7. 3KRemodeling ship and have no employees These sub-contractors have S. ❑Demolition workingfor me in an capacity. employees and have workers' y p �'•- 9. ❑Building addition [No workers' comp.insurance. comp.insurance.: 10. lectrical repairs or additions. 5. We are a corporation and its eP r ed rp 3. I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself~ [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t F. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required] `Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have ' employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: • Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi r the p ns and enalties of perjury that the information provided above is true and correct Si ature: Date: dly ha Phone#: 0 41 17v Official use only. Do not write in this area,to be completed by city or town off ciaL 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 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 certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cant'workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts ; Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFl, Revised 4-2407 Fax#617-727-7749 www,mass.govidia - - ._ '_ �..:. � S r.�r`_►� c..K spriw 4 -'.� ..+mlee q,rw..411 15:. arow.r, 7. Fvvl 04 620 - tp --- _ , 7-L— F 4.. ,: F I i �kl II �•_I li I—_�. ___ .._ fit LO • .I l - - LEJ . I - = �oF: 3 a J _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �� Permit'# IMP.P �7 LICANT MUST OBTAIN A SEWER ' '7"NECTION PERMIT FROM THE Health Division BNGINEERIN Date Issued (i DiV1b1lON PRIOR TO ���'Ro�rlox , Conservation Division ; / Fee p` Tax Collector `��� /f /� 1d •C�® Treasurer Planning ept. , x ' Date Definitive Plan Approved by Planning Board } Historic-OKH Preservation/Hyannis ` Project Street Address )q Village Owner MbQ_PJ S J4C4 0AJ JnO410AJdress e, Telephone (b 0 171- 9ag 76 �/-'Sail- 3`fs6 . t Permit Request d P!12C'- Al W 6 Hv'V46 Tb ab e_ Square feet: 1 st floor: existing j�f proposed f q T 2nd floor: existing ..proposed Total new Estimated Project CostW LID,1b Zoning District Flood Plain Groundwater Overlay Construction Type 5 7_j 0 ' 6 U ar HIW, Lot Size /11�YOD Grandfathered: ❑Yes ' ❑No If yes, attach supporting documentation. r Dwelling Type: Single Family A Two Family ❑ Multi-Family(#units) Age of Existing Structure • I Historic House: ❑Yes No On Old King's Highway: ❑Yes l0 Basement Type: ❑Full ❑Crawl ❑'Wal out ❑Other iv/r+ Basement Finished Area .ft. (sq ) . Basement Unfinished Area(sq.ft) Number of Baths: Full: existing �.. new Half: existing new` Number of Bedrooms: existing-3 `new Total Room Count(not including'baths)-existing new First Floor Room Count Heat Type and Fuel: `KGas ❑Oil ❑ Electric ❑Other ' Central Air: VYes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes WNo - Detached Oge:❑existing O new size ­b— Pool: ❑existing Q new size Barn:❑existing ❑new size Attached garage:lie existing ❑new, size Shed:❑existing ❑new size 4)— Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes �No If yes,site plan review# . Current Use S 11 X tC Proposed Use r BUILDER INFORMATION Name_ b ���� Telephone Number Address :yLicense# r Home Improvement Contractor# Worker's Compensation# - 9 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO U A P15, bO Y 6't PnsA- ATURI�k DATE B FOR OFFICIAL USE ONLY '' • . PERMIT NO. DATE ISSUED . ," ;. ,.• � - � . _ r • --. ' • : ' .. MAP/PARCEL NO. t r .c ♦ � Y , _ .'$" y ,I - _„asp v � - - -• F -_ .` ~ Y, r i ADDRESS , VILLAGE. •.OWNER ' t. ;�; _ '• - � � • Y � L.: y ' : -- ' . � r � s - • DATE OF INSPECTION: s t r FOUNDATION- -£,` •- r _ , - ,. _ • FRAMEtv rn INSULATON' ' FIREPLACE ELECTRICAL: ROUGH FINAL ^ PLUMBING:' ROUGH FINALT GAS: ROUGH FINAL 'FINAL BUILDING.,t DATE'CLOSED:OUT ASSOCIATION PLAN NO. ; t t , t , • 1 Assessor's map and lot number v SEPTIC SYSTEM MUST BE j INSTALLED IN COMPLIANCE Sewage Permit number .................. ./.0 `{.................... E 66 { V1/ITH'TITI. 5 ENVIRONMENTA CODE AND �Qy�FTNEt��O TOWN OF , ;BARNSTA9ti TIONS t fp •w J _ E B AWN 9TAUBL i s 9� QY BUILDING � IHSPECT;OR i APPLICATION FOR.PERMIT TO Ge.. - �.y� .....ke .� `L.`..... .. �......................:. -TYPE OF CONSTRUCTION .............. "r.. ............................................................................ ................... ........ . ...........19.7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........:Z-9......... WXQVAIXS.�.....................: ........................... ProposedUse ...... /L `L.! .......................................................................................:..... vQ / . ZoningDistrict ...................... f-.....................................:.Fire District ..... ........................................... Name of Owner `y n7.....Address�1. ./ ...... Name of Builder ........... .....6-2p..............Address ... .g. .... ..F `�.�{.......................... Nameof Architect .:...................................:............................Address ..:................................................................................. Numberof Rooms ..................................................................Foundation ..... ............................................ Exierior ................................................................................:...Roofing ............ ... .. .. ............................ Floors .............................................Interior ....... . . ..........!s:e...............P.................................. Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .......e;� ..........*..... r'...............A...... Definitive Plan Approved by Planning Board ____________________-----------19________. Area ITT, .. 00 'We Diagram of Lot and Building with Dimensions Fee '�........ .................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 47� Name ... Morrissey, Edward F. 21496 r'K-;;• No .2AA,86..... Permit•for Fjnc,1,use---BrVeez ay . ................................................................. ..... ....... Location........ ..................Hyai�inis.............................................. Owner ...FAward--Horri:S-Sey............................ Type of Construction .......Fe........................ ............................................................... ................ .Plot ............................ Lot .............................. Permit Granted ..............July....25........19 79 Date of Inspection ..................................:.19 Date Completed ......... ............19 Lo . ....... . ,PERMIT REFUSED ....................... ........................................ 19 M ........ ... .................................... ...................... ............................... ......... 4S .......................................................... ............ 0 t; A p Rio 87-e dl a t I ..................................... 19 .......................................I........... M ............................................................................... Assessor's map and lot number ............. Sewage Permit number ..................................... �L 7HE.T°�� TOWN OF BARNSTABLE Z BAR35TADLE, i °o "b q . BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... ......: .......:f..............:.�. `<.�t........................!.....:::..... :......... TYPE OF CONSTRUCTION ....................`......1. `..!.................`....`!c................................................. ........... ......: ......................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....................................`.t.:.........._.......... ...............r. l am]A1f1i ................... ProposedUse ..............!.. ...!....f :...............cL<>....................................................................................................................... .Y Zoning District .....................:..I.....q........................................Fire District .......`. 1: �:: +. .,.....4.r._..r . ........ ............................................. Name of Owner �t...2 � /f•, .1°'Ic`;: ; .. ..Address ��.. ;t a' ......... ....��.:�:...I: �.......:.:.. .... ... .. .... ....:. .. ... .... ... .. .... .. _ t ' Name of Builder ..............Address .. � ... . . .� . ) :......fir........................ Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .....:........................................................................ Exierior ...Roofing .. � .....,. '.t.rc+'" ..................................... Floors .................... � ...................................................................Interior ...........i...:............r...........J......�..�..................................... Heating .....................:............................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ......................`•.................................................. Definitive Plan Approved by Planning Board -------------------_-----------19________, Area Diagram of Lot and Building with Dimensions Fee ' SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r Name . ...•............. ....................... ............................... � � . . . � . . . � � � / ' . ' Permit Type of Construction 1"-r Date Completed ..........).........................19 PE MIT. REFUSED /PEM17 Morrissey, Edward F.- A=3 06-133 —~~~~~~----^'—~^—'—^---^' Approved ---------------.. lQ ' --------------'--^'—^—^^'---^'' � ----^--`---'----^'----'^^'`'~^~^'' | ���� . .......... DATE(MM/DD/YY) .............. ... ............. ............................................................................................................. 0 3 ACORD, ........ : : lT U R A N.-C. ....................... ... .A-*'-..'..--.-..T.......'....--...-' .A........... ........ . ..................... . ....... ..... .......................... 14/00 PRODUCER, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE NORCROSS & LEIGHTON INC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR HTTP: //WWW.NLINS.COM ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 437 STATION AVE COMPANIES AFFORDING COVERAGE S YARMOUTH MA 02664 COMPANY A MARYLAND INSURANCE INSURED COMPANY MURPHY RESTORATION & B REMODELING, INC COMPANY P 0 BOX 739 C YARMOUTHPORT MA 02675 COMPANY D ...................................y.......................... ... ........................ ........................ ................................................. ....................................... ............................ ............... ...... GE�...................... ..................... .......................... .. ................................ ......::'***, -xv ....................................................................... xxxxxxx, .... ... ........................................................................................ ..........%.........­.......................................................................................................x.............. ....... ......................................................................................*............*......... ­........ ........ ..... .. ....... ....... 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION umrrs LTR DATE(MM/DDNY) DATE(MM/DDNY) GENERAL LIABILITY SCP35701623 10/20/99 10/20/00 GENERAL AGGREGATE s2, 000, 000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG s2, 000, 000 ...... CLAIMS MADE X]OCCUR PERSONAL&ADV INJURY $1, 000, 000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $1, 000, 000 FIRE DAMAGE(Any one fire) $ MED EXP(Any one person) $ 10, 000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ .................. ....... ....................... ANY AUTO ^ OTHER THAN AUTO ONLY: .I.................1.11................................................... EACH ACCIDENT $ 1 AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ OTH. ........... .............. WORKERS COMPENSATION AND ON ORDER 3/14/00 10/20/00 X I TWOCRYSTLIAMPTS' I I ER EMPLOYERS'LIABILITY EL EACH ACCIDENT $ 100, 000 THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ 500 , 000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 100, 000 OTHER DESCRIPTION OF OPERATIONS/LOCA71ONSNEHICLES/SPEC[AL ITEMS FOR OPERATIONS USUAL TO A CARPENTER ............. ........... ......................... ........... X 'Alm .................................................. ............ ................ ............................................................................................... .... ......... ............................................................................................................. ............ .............. ....... . ........................................... ....................... XXIX ................................................................. .............................. .......................................................................................................... ............. . ....... ........... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TOWN OF 13ARNSTABLE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 367 MAIN STREET BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY HYANNIS MA 02601 'ok 0Y KIND JUPON THE CO ANY, ITS SAENTS OR REPRESENTATIVES. V LS C ............. ................. .............................................. ............... ::: 0 ............... ... .9. : 11 ::A, .........................­................. ............... ......x.-`­:*:......................................... . ............... ... .................... .. ....... ........ ........ 01,1H9r, Department of Health Safety and Environmental Services Building Division • sActrtszi►eM • 367 Main Street,Hyannis MA 02601 UAS& i659. ��lED MP'1 J, Office: 508-862-4038 Ralph Crossen Fax:. 508-790-6230 Building Cotnmissi, HOMEOWNER LICENSE EXEMPTION Please Print DATE: G� �1 -�`�.. / ! JOB LOCATION: �� "� t K t=r=t > '` ®v / village number street .HOMEOWNER": A" 0� 4 &JQAJ [ —n>X -70 name ,e' home phone# work phone# 3 � CURRENT MAILING ADDRESS: " hV� 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 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 Depa t minimu inspection procedures and requirements and that he/she will comply with said r ce es req i e ents. rgnature o H eowner 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 persou(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. Q:F0RMS:EXE1\1 N ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE �r� � ` square feet X $55/sq. foot �� � GARAGE (UNFINISHED) square feet X $25/sq. foot= PORCH square feet X $20/sq. foot= DECK square feet X $15/sq. foot= OTHER p G1 ��� square feet X $??/sq. foot= Total,Estimated Project Cost g990915b c' ._rd of Building Regulations and Standards One Ashburton Place - Room 1301 Boston , Massachusetts 02108 Home Improvement-,-Contract r Registration- = ;, a -------------- ---------- ---- -- Registration: 129943 Expiration: 11/29/2001 4 Type: DBA � °J,���,�u�dlr�a�✓llu�• OME IMPROVEMENT CONTRACTOR Registration: 119943 MURPHY RESTORATION & REMODELING Expiration: 11nVZOO1 JOHN MURPHY :°' Type: OBA 1 JI3STAY RD . YARMOUTHPORT MA 02675 MURPHY RESTORATION & REM00 JOHN MURPHY YBSTAY RO. ADMINISTRATOR YARMOUTHPOR MA 0261S The Commonwealth of Massachusetts Department'of Industrial Accidents -� �=:' �_�•• � Offlcr nf/trvestigadoas -� - 600 Washington Street Boston,Mass. 02111 r Workers' Co m ensation Insurance davit name: '` location , L hone# 15d V , 7?i- ��'�j city , ❑ I am a homeowner performing all work myself. ❑ I am a sole etor and have no one worldz in any capacity %ama sol/ orkers' co ensation for my employees working.on this job.: ❑ I am an employer providing w mP . com any name. .. _...........:::;.: insurance co. ... I am a sole proprietor, general contractor, homeowner ' cle one)and have hired the contractors listed below who the following workers compensation p .; ;>:;:>:>;::::>'<:::::>::»>::>:>:>:> any name . address- a .....: ............ .. .................. ... ... .. ....... ..... ... ............. .. .. .... ......:n�:.:�.�:::..:...........:•:::::::v::;•.is O. .................... ...... .... ... .. ........... .... .... ..n.. .... ... :::..; .::: {S•iii<:•inPi:ii:•iii;9i:•iiii:•:iJ:•:::^i:::ii..`: . ... F ,.. hone ;;;>•�:;:.:;•;;:::.>::... y... u .. z ..�.. tP T� a { .... .•::::.... insurance cm ::>:.:,::::. ;:'.::,:;:.;:, _.: <: i;:::;:;;i >:;:»i:`s>::»::»:2%%C<>:«:>i.+?:?;i';i;ot:>:[i:?aiz`::.i;i;i :;¢5:;::;ii:^:i::;:::;;.:�<::<:i:;::;.::;.::.:;;a any name:- ^:::;:::; address- ......................- :: .:•::i::::.: t . .:i.;;:: .::::.i:.... : ...:...:.. ...:. :::i:•:Ki:•::•i:i :?:�::�':i'�:�v:�:{:iri::ii:i:::iii:�:ii:i::i::;i:;:::i is ii::.i::: .. < �:::�<><: ...: ................:{:.:::i::...........�.�::•:::: :•:}:•:::::::•::::••::•::T:ii'•:{.;::;:;..:•::i:Fiw•i:,4:•.<::•iii:•i$•{•�:.:'' .;}•:.i'•'r�:4Y::•:ti::•iii:iiiiii:! ...:........::.: insurancexo.. �• llnre to secure coverage as req�red under Section 25A of MGL 152 can lead to the imposition of erhainai penalties of a 8ne np to S1.S00.00 and/or Fa one yam,imprisomnent as well as civil penalties in the form of a STOP WORK ORDER and a flue of 5100.00 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 c and nalties ojperi that the inG I It provided above is Inw mid correct 1). Date 3igaatu72 Print nam °F. official use only do not write in this area to be completed by city or town oftldsl aBuilding Depard ent perinitNcense# � [3ucensin , city or town: i g 13selectmea's Office ❑check if immediate response is required ❑Health Department Other contact person: phone#; - ❑ (tevued 9/95 PJA) hun iptfre PatkaM for aa*and Two-Famdy RaidemsW BuddLM Hated with Fool FaeL MAXIMUM Nl�IQ1Itll41 f Wall Floor S mom Slab Hwun#CDWin8 Uwaiom: Bry d=: R-what p valud Wi11 P� Ema� P=imIIe Rrvabtet &valod 5701 to 6500 Hulot Degm D&W Q 12% 0.40 31 13 19 10 6 Normai R 12X 032 30 19 19 10 6 Normal S IrA 010 31 13 19 10 6 M AFUE T 13% 026 31 13 23 WA Nottaal U ts% 0.46 3s 19 19 10 6 N=nW 1► 137i &44 �0 1. w ivn :.::. !S AFUE W 13% 0.32 30 19 19 10 . 6 tS AFUE X tl% 0.32 31 13 25 1 WA WA Normal T is'/. 0.42 31 19 25 WA WA Nanud Z 12% 0.42 3s 13 19 10 6 . 90 AEUE AA is•/. 0.50 30 19 19 10 6 90AFUE 0 1. ADDRESS OF PROPERTY: Cum N uyl— I SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING; � 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q—AA-see chart above) e NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-i980303a r • anxrrsrnaLE, • nstable The Town of Bar 9�A MASS, �0� Department of Health Safety and Environmental Services >En 3 . a Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 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-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: -My®eVAJ6 -C 5CS(NJ;S !10A Estimated Cost ®` Address of Work: Owner's Name: A-/U bg&7J S ,,J—ftt0 A1 d A) W&6 Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ;Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.'142A. SI D UNDER PENALTIES OF PERJURY I hereby apply for a pe t as t geqt of the owner: Date L.,7 49oa4aGtQLXame AO�bp_EGJ L ieu-No. R Date Owner's Name ;TCV q:fonns:Affidav v�k I I I r� E, i -- � a� X yam' 6 • �X- C t hU ' I x k � I I c I _ 11W6 S i - jj Z —2 e - — -- —n S ;ua , i 1 _ Eq 0 amn eaa l - 3�tix le � n � by 1. 4g 0. z PAP +N,area le to >'V ► 9 ,_7.�Z .f i I - p i 11 Ji Kam;.AIA - I I , , I- 1&17 — I��,OSET I clos �r I -- - Barnstable Bldg.-Dept. Approved by: ;AvQ CINUL I --4 I — — I —J- AK Low �L �--- }- —INJ r - 4 1101 � I IIl I I II I i � -- I �l I - V i _ ` 19 �z l i I I kt i I I i 4- Al 2t E V. 1 it I I