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HomeMy WebLinkAbout0007 DARTMOUTH STREET r7 -Ta -4-►-.o,.L -k , ; r � ,. Town of Barnstable..�..tiA"..:.J""^""'"`°n.•^.y.^--^_ -m�.....�....w,-�.� -�,ey..,.....A*.y,,.....M,..,..r.,. ,... ..w.-,,... ..n.�.++�ww-;,..,,M.-e."'S"' ..*..�«+•. .. -,., ..,„..�.,,;+Yw,. .�,.r.. Building 1Post.This Card So That it is'Visible From the Street Approved Plans Must be`Retamed on Job and this Card Must be Ke'Pt t anxnsrwBl E r a- , Posted Until.Final lnspectign'Has Been Made , D^y. �� �63p 1�S' 1 cl -:. ,en{' Where a Certificate of Occupancy is Required,such Building:shall Not be Occupie ntil a Final Inspection has beemmade`� 44 Permit NO. B-20-46 Applicant Name: W. Ray Colwell Approvals Date Issued: 02/03/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 08/03/2020 Foundation: Location: 7 DARTMOUTH STREET, HYANNIS Map/Lot: 307-128 Zoning District: RB Sheathing: Owner on Record: TAGEN,KATHRYN M Contractor Neme: SC Energy Framing: 1 . Address: 27 VILLAGE ROAD R" Contractor License., 194390 2 MANSFIELD, MA 02048 a .° Est Project Cost: $3,917.00 Chimney: f y: Description: Insulation;See.Contract - Permit Fee: $85.00 ' 1 Insulation: Project Review Req: f s' Fee PaidF: $85.00 < -Date. 2/3/2020 Final: " , w ��� Plumbing/Gas w v Rough Plumbing: -,Building Official Final Plumbing: This p ermit shall be deemed abandoned and invalid unless the work authorized"by this permit is commenced within six'months afte'r'-,issuance. All work authorized by this permit shall conform to the approved application and the approvedconstruction documents for which this permit has been granted. Rough Gas: r f use f an building and structures shall.be in compliance with the local zoning b -1aw'sand'codes. All construction alterations and changes o o p g Y g Y g This permit shall be displayed in a location clearly visible from access street or road.and shall be maintained open for public inspecti n for the entire duration of the Final Gas: work until the completion of the same. ' ' --. .„ •,---� - "'� :` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the.Building and Fire Officials are"provided on this'permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing 2.Sheathing Inspection ww ` Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set,forth in MGL c.142A). sc Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map f y Parcel Application #Q0 d Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project-Street Address T l�Rirrry �H �� -Village, Owner 90BB,97:-d kaffe&,&J Aia)&s Address,? U/LCAGw ~100TFi;ZJ L -" Telephone 56 -/ -Permit Request o n. nA* � Lew S Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new, Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing :❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name. 14&6s &-iii tTelephone Number Address ' rmg 0—Y rLicense.# - -CS 10q&-1Z MINvr_116�0 vAvt Horne•Improvement.Contra_ctor# 9�9� Worker's Compensation# �,.�779!flJSJ -,-ALL CONSTRUCTION-"DEBRIS RESULTING FROM.THIS.PROJECT WILL BETAKEN TO ' 7 SIGNATURE DATE 05 4 FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER t DATE OF INSPECTION: SAFOUNDA,-Til0..N!JAmi tulvtr riufmk:.- _ FRAME .INSULATION,i-A Ss ;r ll4't ULA V! FIREPLACE ELECTRICAL:- ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING1: " t DATE CLOSED OUT ASSOCIATION.PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): L Ew r.s LErnad FL/, k q- Address: 2 dpX ai City/State/Zip: D Phone#: — (® - as-b Are you an employer?Check the appropriate box: Type of project(required): o� i 1. am a employer with C 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. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in an capacity. employees and have workers' y p n'• 9. ❑Building addition [No workers' comp, insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑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. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: L/,6,6 7tz ° �z>m"'4 Policy#or Self-ins.Lic.#: JJCJ. R/S— .372��f q-0,�,9 Expiration Date: 1211,31119 Job Site Address: 9D�27n�OGlTf� AeE City/State/Zip:. hl�/ lil.5 /,-/W 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 certify under the pains and penalties of perjury that the information provided above is true and correct Si ature: Date: ! %3 Phone#: ,�� "�_,qd5U 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): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r 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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure,to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the O:ffice_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 0211.1 Tel.#617-7274900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia From:Barrows Ins. Agency 1 508. 339 9524 05/22/2013. 09:28 #477 P.001/001 ,4coiro® CERTIFICATE OF LIABILITY INSURANCE FDATE 5/29/70131) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy()es)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(!). PRODUCER BARROWS INSURANCE AGENCY CONTACT NAME: 215 NORTH MAIN STREET MANSFIELD, MA 02048 PHONE A1C No: E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC B INSURER A: LIBERTY MUIUAL FIRE INSURANCE INSURED CARLOS LEWIS INSURERB: DBA LEWIS REMODELING &CARPENTRY INSURER C: 2 OAK STREET INSURER D: MANSFIELD MA 02048 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 16424578 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR EFr LTR TYPE OF INSURANCEihm POLICY NUMBER MM%DDY/YYYY MPOLDDY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ C DAMAGE TO RENTED OMMERCIAL GENERAL LIABILITY � PREMISES Ea occurrence $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS.t�0 f OP AGG $ N POLICY PRO- LOC $ W AUTOMOBILE LIABILITY COMBINED SING LIMIT Ea accident) ril! $. ANY AUTO BODILY INJUF,�X1P#rperson) $ ALL OWNED I I SCHEDULED AUTOS L�_J AUTOS BODILY INJURyi(Pyr accident) $la _ NON-OWNED D PeOaCEI'd' ntDAMAGE $1 A HIRED AUTOS AUTOS $3a. U1 UMBRELLA LIAB OCCUR EACH OCCURRENCE $'�Ci EXCESS LIAR CLAIMrS-MADE AGGREGATE $W DIED RETENTION$ $ 114 A woRltERs COMPENSATION WC2-31 S-377849-032 12/13/2012 12/13/2013 WC STATU- 09- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? ❑Y N E.L. /A EACH ACCIDENT $ 100000 (Mandatory in NH) _ E-L DISEASE-EA EMPLOYEEI$ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Ramer"Schedule,If more space Is required) THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR CARLOS LEWIS Workers compensation insurance coverage.applies only to the workers compensation laws of the state MA. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA 02601 AUTHORIZED REPRESENTATIVE Jeff Eldridge . ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT td0.: 16q 2457E Anne Chandler 5Y2/2013 5:0i59 16 certl icate cancels an 3uperse es ALL previously issued certificates. JVlzessuchusctts - Department of Pubiic Sa�'ch 9 `Board oi' Buildinlg Rc!-rulations and Staud.ards"I Construction Supervisor License ' L'icenie: CS 104619 CARLOS LEWIS 27 STURbY ST" i NORTON, MA 02766 y., Expiration: '9/12/2013 r f+nnniissi mcr Tr#: 104619 e o+(i/�l�•I:Irir'�i�;i�r//1 S- Office of Consumer Affairs&Businee Ide+lii+ition �' License or registration valid for individul.use only ME IMPROVEMENT CONTRAC.1JnR' n before the expiration date. If found return to: egistration: 159692 Type: Office of Consumer Affairs�and Business Regulat�o►: .t - xpiration , 5/19/2014• DBA 10 Park Plaza-Suite 5170 s _ ` 1 Boston,MA 0214 LEWIS REMODELING&CARPENTRY CARLOS TLEWIS 27 STURDY ST _— c NORTON,,MA 02;7,66 Undersecretarj Ncrt valid without signature'` THE Town of Barnstnhlp- Regulatory Services BARNSTAB9Q IE�* Thomas F. Geiler, Director Dp 1639. rfo,,,A�A 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 NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY I, W L, &J15 , Construction Supervisor License # �pSlGj�' , hereby certify that I have assumed responsibility for the project under construction as authorized b buildin it# I�� , issued to y g p erm (property address) 2 b27rrlyt'r711 AyCy��tiis � on , 2019 . The following documents are attached.: copy of my Massachusetts State Construction Supervisor's license. or Homeowner's License Exemption form (if applicable) copy of my Home.Improvement Contractor registration (if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond (if applicable) 44110 s LICENSE HOLDER DATE q/forms/newcon trb rev:1 10410 �TME Town of Barnstable Regulatory Services BMMSTABMMAGG ` Thomas F.Geiler,Director 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 NOTICE TO THE BUILDING DIVISION OF CHANGE OF CONSTRUCTION SUPERVISOR I, W/uWZG ` , owner of property located at &Wei-ZI-6 �}✓T i�N s , hereby certify that (2OA o longer Construction Supervisor listed on,the application for the project under construction as authorized by building permit# 1c1 t� issued on 20--3 I understand that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. 7 � PIZOPtRTY R IDATIE q/forms/newcontrowner reference R-5 780 CMR rev:11211 Town of Barnstable _ Regulatory Services t R�RN�TART.R t - KAss �+ Thomas F. Geiler,Director Building Division - Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.townbarnstablema.us Office: 508-862-403 8 Pax: 508-790-62 Property Owner Must Complete and Sign This Section If Using A Builder Zgi—A *- - 2�67' , as Owner of the subject property hereby autholize �L�,e�v 5 ei,�, to act on my behalf, in all matters relative to work author zed by this building permit ' C �.C/ (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Ownet Signor e of Applicant Print Name Ptin-t Name 3 713 Date Q:F0RIv2:0WNERPEx1MMr0NPo0Ls 6/2012 , a Town of Barnstable iTti Regulatory Services K Thomas F. Geiler,Director * RAMNSIAMM . K`` Building Division pry Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Fax:.508-790-6230 Office: 509-862-4038 HOMEOWNER LICENSE EXEMPTION Please Print DATE: i JOB LOCATION: number street village "HOMBO WNER": name home phone# work phone# CURRENT MAIIJNG ADDRESS: city/town state zip code The otnrent 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 Persons)who owns a parcel of land on which he 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 structu c A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such ch "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 i The Code states that "Any homeowner performing wor-k.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 pmon(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, ds the responsibilities of a Supervisor. On the last page of this issue is a form that.the homeowner certify that he/she understazr currently used by several towns. You may care t.amend and adopt such a form/certification.for use in your community. i Q:forms:homeexempt YOU WISH TO OPEN A BUSINESS? For Your Information: 'Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this format 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office,.1 st FI.., 367 Main St., Hyannis, MA 02601 (Town Hall) and 'get the Business Certificate that is required by law. nm DATE: O Fill in lease: & APPLICANT'S YOUR NAME/S: J�egwe4 ►` y1�!►�A t j `j i3 ' BUSINESS YOUR HOME ADDRESS: 6;r Sea 6+ , LAB;} /♦ a , If,-A1 ✓ r5 O ©1 9-5 h E #� TELEPHONE Home Telephone Number ��� 5 4� SL2 ,. NAME pF CORPOF ATION '.NAME gF.NI=lN B(1,51lyEF35 TYPE OF BUSINESS .5 � �e. e"C, IS THIS A HOME'OCC(JAXI�]N? YES , NO + +� (AP{.Cvt1 �Ll AbbRESS 0 BU5111�ESS� ; '; — " 1 �t 'hl` 14 `.)L�c- Ofb! iVIAp/PARCEL.NUMBER (Assessing). �93 When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town.of _ Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO ISSIO R'S OFF This individ I e in or d . an earrylit re uirem nts that pertain to this type of business. izedmqt COMMENT 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: S.-CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: ',d.: . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel - Application 0 o f Health Division Date Issued 4 a_ 1 J� Conservation Division Application Fee c� Planning Dept. Permit Fee 001 ` `c Date Definitive Plan Approved by Planning Board ' -Z /3 Historic - OKH Preservation/Hyannis Project Street Address r7 Village yvr�i 5 Owner Address -7 U/�,1A G- �� lY2r�s C r! Telep�hoG �a14 +_ Permit_Re nest S'�i�e1� �F sywJ,�; suL14� i✓ew d��y * 4Ar� �i ,� i✓ S`/lec7Qrx�l�Ri ��vn, �fz6.,✓ ST �<�,2 �5'sb 'Cr s�4wd Fl ¢Si 3y Square feet: 1 st floor: existing.i'S D proposed.550 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay, Project Valuation`t 0� coo —Construction Type Lot Size Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) _ Age of Existing Structure 7 q Historic House: ❑Yes gNo On Old King's Highway: ❑Yes 4 to Basement Type: >kl!�ull ❑Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area ft) w Number of Baths: Full: existing new o Half: existing --raow t Number of Bedrooms: existing O new —' . av Total Room Count (not including baths): existing newer_First Floor R om Count T— 4F Heat Type and Fuel: 4"Gas ❑ Oil ❑ Electric ❑ Other w r9 Central Air: Yes ❑ No Fireplaces: Existing New 0 Existing wood/coal stove: ❑Yes No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size Shed: ❑ existing ❑ new size Other: 9 9 9 9 — Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Slw ke kam,Z Proposed Use - _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Na�0 i#9Yr� TAGQ�� Telephone Nu`rrifjer ����37' 0PO Addr � ,�t�2T� h?�vli License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FR M THIS PROJECT WILL BE TAKEN TO SIGNATURE r DATE 1 3 r' r: FOR OFFICIAL USE ONLY I• APPLICATION# s DATE ISSUED ' MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: _FOUNDATION- s . FRAME M� INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL F: PLUMBING: ROUGH FINAL ' - GAS: ROUGH FINAL FINAL BUILDING f DATE CLOSED OUT ' ASSOCIATION PLAN NO. a1'11 � �� #�`�` � 4 �o 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 A" licant Information Please Print Legibly Name (Business/Organization/Individual): 1 I (� Address: r`►� �,�`t'h City/State/Zip: L4d n r� I",s Phone Are you an employer?Check the appropriate box: Type of project(required): I.❑ I am a employer with 4. I am a general contractor and I 6. ❑New construction employees(full 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. workingfor me in an capacity. employees and have workers' Y P ty 9. ❑Building addition [No workers' comp. insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 L❑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 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$1,50.0.00 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 v rification. I do hereby..certify der th pains an en o erjury that infor on provided above is true and correct, :Signature: — Date: - Phone Official use only. Do not write in this area,to be completed by city or town offciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and .Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more .. of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee.of an individual,partnership,association or other legal entity, employing'employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on.such dwelling house.` or on the grounds or.building appurtenant thereto shall not because of such employment be deemed to bean employer. MGL chapter.152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a Iicense 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-contractor(s)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the` members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial . Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town.that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please.call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current. policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or, town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the.' . . applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum 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-NIASSAFE Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia f VE Town of Barnstable Regulatory Services BMINSrAsr.E, Thomas F.Geiler,Director r MASS. 4i,, 1639. ,�� Building Division TFD MAC" Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 7 Please Print DATE: JOB LOCATION: / J,---}y�n " �nummb �1 - kt�j� ber street 1 / village .HOMEOWNER":" 'd LS�(f"p�� b CS" 0?6S_/6(// name home phone# work phone# CURRENT MAILING ADDRESS: O` / /ld m)ns e IJ M d 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" rtifies that he/she understands the Town of Barnstable Building Department m;r;mum inspection pr ced d requirements and that he/she will comply with said procedures and req it ents Signature of Holgeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with_the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use.this exemption are unaware that they are assuming the responsibilities of a supervisor(see.Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt OF THE rql� Town of Barnstable Regulatory Services MASS, Thomas F.Geiler,Director Argo.39. a 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 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS 62012 .. 1 TOWN OF BARNSTABLE 7013 APR. - I PM 4- 13 -f DIVISION KE DETE ORS REVIEWED BARNSTABLE UILDIN EPT. DATE IN DATE FIRE DEPARTMENT BOTH SIGNATURES ARE REQUIRED FOR PERMITING 'T O 13.. E ALARMS r CARBON MONOXID r l MUST BE INSTALLED PER MASSACHUSETTS BUILDING CODE Wj _7 4_4� 160 �m p IV / •y-R Hyannis fire damaged by fire CapeCodOnline.com Page 1 of 1 xml Hyannis fire damaged by fire By CAPE COD TIMES February 14,2013 2:53 PM Fire damaged a house on 7 Dartmouth Street in Hyannis this afternoon. A smashed window in the front of the house was charred outside. Smoke was still coming out of the house at about 2:50 this afternoon. But specific information about the fire and damages was not immediately available from the Hyannis Fire Department. Content blocked by your Copyright©Cape'Cod Media Group,a division Organization "of Ottaway Newspapers,Inc.All Rights Reserved. Reason: This Websense category is filtered: Streaming Media. URL: http://www.youtube.com/embed/ZzpozDkPwcQ t Options: Click more information to learn more about your access policy. ................. ......................... ........... h '- _. Click Go Back or use the browser's Back button to return to i= http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20130214/NEWS 1-I/13021986... 2/14/2013 s Assessor's map and lot `nu ber d.7..'./ ....... O h!.,., �oF THE toy► 3 Sewage Permit number �. ................ ......, ... I . Z BpA,"STA DLE. House number ..7.................................:/ ............ ...... Mae& MPY TOWN OF 'BA.R.NSTABLE BUILDING INSPECTOR I 1�....L........1 X.. .... :..'.. ........................:.......:......:.. APPLICATION FOR PERMIT TO A& TYPE OF CONSTRUCTION . .................................................................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according to the following information: Location /..... ........ ,t `/L.1�............................................................................. Pro posed Use . �::{ / ...........................�u '... ':: .r�%'................................................................................ .... .;,� Zonin District //nnz✓:j .................................... /� ri✓/1�./ g ,�i Fire District .......... .........................................�........................ Name of Owner ..�.� r.....�.1-��°l/ !.�'�!..'.: .................Address 1. . /'1����!'�r!...... I' Name of Builder' ..AXE /� . `2',� . ................................................/ � ........ ".....................................Address ......................... � Nameof Architect �� ...Address............................................................... .................................................................................... Number of Rooms .....................Foundation l,.f'.° � i�'�.� Exterior .!'���/ C!"�/ �`�fj r .s f/ �✓ ..�,!.. .....'.. . .C7.. .................................................. ................ ..... ..........Roofing .. Floors ......................................Interior --.................... Heating / ...J..... r....:. .......Plumbing �... Fireplace ��`'"' .Approximate Cost Definitive Plan Approved by Planning Board ---------------_----------------19_______. Area ............ ...................... Diagram of Lot and Building with Dimensions g g Fee ...........*-.,/..�........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH i / / / %I ty OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam e '%: �� ....::: � �-./......................... 01SULLIVAN, K. 24147-, Build Addition No ................. Permit for .................................... ...-Single Family Dwelling .................................M............ 7 Darthmouth Avenue Location ................................................................ ,Hyannis Owner.....K.......0..'..S...ul.l..ivan ........................... Type 'of Construction ..............Frame............................ ................................................................................. 4 'Plot ............................. Lot ................................ June 21, 82 Permit Granted ........................................19 Date of rn-s4,Wior7 ......................19 Date Completed .................................19ff ' Assessor's map and lot number ...................... yp%THE r0� ` z 3 f Sewage Permit number :..........x.... .::. ✓c.....I.......... ..: f� `� Z w``P R �+► ' 1t BAHBSTADLE, i House number MAO& 9 ODo,i639, �Ea NO a' TOWN OF BAR.NSTABLE BUILDING INSPECTOR ' x i z. APPLICATION FOR PERMIT TO � � � a TYPE OF' CONSTRUCTION w©ry f'��! �' (fUL.........f.............19...�Z TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........`../..�'`�'*' �� ��/............................................................................ Proposed Use �r�cf. 7.o 2 . /z.....u'tC x,/? ...?.�°' ............................................................................... Zoning District �YI!'J/f ... ..Fire -District ! l/ �7 / f............... ................. v r v4 Name of Owner .... .......�..:�!. ��. .............................Address i v .... .....�:!!•//✓ Name of Builder ..��G /d .... ,,,.....y......................Address ........... ..............................................7S...... o`j e Nameof Architect .... .....................................................Address .................................................................................... Number of Rooms ...................Foundation ...,..,....... ..................................... ..... ..... ���f Exterior .......................'.`....a.� ...........� .........:...............Roofing .. .... ' .c..... ............................................. .Interior e-ex �©e Floors .................................................................................... Heating /' .Plumbing �"1 •%�,rv✓ ,.//. ��' �//lr., ��.,!5r'� Fireplace All....................................................................Approximate Cost .......Oo 6-1 Definitive Plan Approved by Planning Board ---------------—---------------19--------. Area ...........��!!�...................... Diagram of Lot and Building with Dimensions Fee ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH r + OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. NameG�� � / .� C O'SULLIVAN, K. =307-128 24147 u d Addition :E No ................. Permit for ...... .. .......................... Single Family Dwelling ................................... ........?.................................. 7 Location ....... Darthmouth................................................ .................Hyannis ................... K Owner ...........O'Sullivan........................................................ Frame -Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ June 21, 82 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19