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HomeMy WebLinkAbout0121 ESTEY AVENUE ��/ �� 4 _.. -- -' - -� .. _ .. (Y� 1 � t Town of Barnstable , Per0t# Expires 6 months from issue date Regulatory Services Fee y MASS e Thomas F. Geiler,Direc tor r s6 _ �p 39 ` IN Building Division Tom Perry, CBO, Building Commissioner , 200 Main Street,Hyannis,MA 02601 www.towmbarnstable ma us 0ffice: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY ��,-�� - Not Valid without Red X--Press Lnprint Map/parcel Number si Property Address i!l lrl. S [Residential Value of Work 7 ,S - Minimum fee of$35.00 for work under$6000.00 Owner's'Name&Address L l sAl . -Vag(, q7 3 r� Contractor's Name � 'rtr la.' CAI mod. Telephone Number Z�l 7 22-oQ;Z Home Improvement Contractor License#(if applicable) '7�. Construction Supervisor's License# if a hcable C uP (� PP � ) C.SS�. •- �c���.�� ��� �'ERM'T ❑Workman's Compensation Insurance SEP 9 Ch one: 2012 eI am a sole p'6prietor ❑ I am the Homeowner TO ❑ I have Worker's Compensation Insurance wN OF B/gRNsTAB LE Insurance Company Name Workman's Comp.Policy# ' Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to' ❑Re oof(hurricane nailed)(not stripping. Going over existing-layers of roof) Re-side of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits'required.. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note:. Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is i Iequired. SIGNATURE: Q:\WPFZM\FO S1buildin eruct forms%MRESS.do Y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations + d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print LeLyibly Name(Business/Organization/Individual): . Address: City/State/Zip: _ `f MA d2(,3S, Phone.#: 71 7.d!w, Are you an employer?Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I . . ployees (full and/or.part-time).* have hired the stab-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 mein am capacity.' employees and have workers' Y - �. 9. ❑Building addition comp.insurance. [No workers' comp.insurance 5. ❑ required.] � We are a corporation and its. 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0>1mbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.RrRoof 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$1,500.00 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 OIA for insurance coverage verification. I do hereby certify under the pains and pe alt• s f jury that the information provided above is true and correct. op Sijznafore: Z4014 Dater f'y' Phone#: Z7'c-f ?;?Z- 69522 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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 apartments3and 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 Jkbe 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. `a 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 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 permittlicense 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 Departments address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigatiens. 600 Washington Street &oston, MA 42111 Tel. ##617-727-4900 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mas i.gov/dia HE Town of Barnstable Regulatory Services *. sARNsi'ABLE, t y ass Thomas F.Geiler,Director 4� i63F9. ,0 iOrEn ►`l" Building Division Tom Perry;Building Commissioner 200 Main Street,Hyannis,,MA:02601 www.town.barnstable.ma.us Office: 508-862-403 8. Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder G-+y d o. ya e— , as Owner of the subject propeity hereby authorize C� 6((',� l ,1'1Fn(;d� 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. L mdQ L!� 11 Signature of Owner Signature of Applicant Pant Name Print Name Date i. . Q:FORM&OWNERPEnlISSIONP00LS 6/2012 h t r `Town of Barnstable Regulatory Services W } 4 iF MRNSTABM : Thomas F.Geiler,Director y MARK �p 1639. `0� 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": 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 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 N, ,M �• Note: Three-family dwellmgs*contammg 35,000 cubic feetf 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),.provid4ed'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 Not �>lee Uanirnoozcue ��°0 ' , Massachusetts - Department of Public Safety Office of Consumer Affairs&B sinessRegulation Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Type: Construction Superi isor Specialt Registration: ,5A72472 YP ; License: CSSL-105951 ;• Expiration fi/2t2,014 Individual ! - •' ' 1 .. PATRICK CLIFFP)RD P I C K CLIFFOR 12 BALD WIN ROAD Dennis MA 02638 i i PATRICK CLIFFOA x L 12 BALDWIN RD DENNIS, MA 02638 „ Undersecretary I I � -� " " ` Expiration + ` Commissioner 06/02/2016 I ' License or registration valid for individul use only . before the:expiration date. If found return to: i Office of Consumer Affairs and Business Regulation i .; 10,Park Plaza-Suite 5170 1: Boston,MA 02116 i � ! Not valid wi nt signature Jr ttt - -z -t r Town of Barnstable �- o Permit# ' Regulato Services r Expires 6 ma Yhs from 'sue date } Fee MASS 1 Thomas F.� Geiler'Director �'prEO Mp2i► 1 Building Division P Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 Office: 508-862-4038 www.town.barnstable.ma us • Fax: 508-790-6230 EXPRESS PERNM APPLICATION - RESIDENTIAL ONLY. Not Vafid without Red X-Press Imprint Map/parcel Number��^} ..r Property ddress �V�p V) ts, Residential Value of Work /PJ a Minimum fee of S35.00 for work under S6000.00 Owner's Name&Address Contractor's Name 2, y �d Telephone Number Yr-;P>X-R- l Z/v Home Improvement Contractor License#(if applicable) C nstru Supervisor's License#(if applicable) 2�Workman's Compensation Insurance 9 —k one: FP PERMIT am a sole proprietor ❑ Tarn the Homeowner OCT 2 02011 ❑ I have Worker's Compensation Insurance � TOWN OF BARNSTA1,,. '.nsurance Company Name `�'�/ Workman's Comp. Policy# 606 �opy of Insurance Compliance Certificate must accompany each permit 'emit Request(check box) 14�e-roofipping old shingles) All construction debris will be taken to ❑;Re-side r of(not stripping. Going over existing layers of roof) " ❑ Replacement Windows/doors/sliders. U-Value #of doors (maximum.4-4)#of windows *Where required: Issuance of this permit does nat exempt compliance with other town department regulations,i.e.Historic,Conservation cm. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is qui 7NATURE: �PFMESVORMMbuilding permit formslEXPREsS ised 070110 f The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestigadons 600.Washington Street Boston,MA 02111 www.mass,gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le •bl Name (Business/Organization/individual): Address: City/State/Zip: Phone #: �S•- Are you an employer? Check the appropriate box: 1.❑.I am a employer with. 4.. am a general contractor and I Type of project(required): 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 working for me in any capacity, employees and have workers' 8' ❑Demolition [No workers' comp.insurance comp,insurance,$ 9. ❑Building.addition 3.❑ required.] 5. 0 We are a corporation and.its 10[Electrical repairs or additions I am a homeowner doing all work officers have exercised their myself. 11.[Plumbing repairs or additions y [No workers comp, right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no 12.D Roof repairs employees. [No workers' 13.[] Other comp.insurance required.] 'Any applicant that checks box#] 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: Policy#or Self-ins. Lic. #:1A/�►LO'����7h19/. • 6 4"17 1 d Expiration Date: Job Site Address: 40tt` '`� City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). fFailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal.penalties of a ine 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 ce er the pains and penalties of perjury that the information provided above is tr a and correct Si afore: 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 Contact Person• Phone#: CHAR .L: E.: S COREY it The Roofees Roofer t Roofing. Cape Cod Since 1. 970 1694 FALMOUTH RD #115, CENTERVILLE, MA 02632 PHONE 1 .504 -775,-4.240; C. ERTAINTEED<< L.A: NDMARK LIFETIME- ALGAERESISTANT ARCHITECTURAL STYLE- May 31, 2011 RE.- ROO' 1= ING PROPOSAL VINCENT VALLE INSTALLATION ADDRESS: 473 BAYSHORE RD 121.ESTEY AVE NOKOMIS,FL 34275 HYANNIS, MA Phone: 941-266-4270 Cell EM: vTossdl�?.macxoan CHARLES COREY hereby proposes to perform the following services in a neat and professional manner and in accordance with the manufacturer's specifications and local building codes. Remove and Haul Away All of the Old Asphalt Roofing Shingles from the Top of the Two Shed Dormers, the Cheek Strip on the Sides and Bottom of the Dormers and the Sun Room Roof Shingles and the Street F acing Part of the Right Addition. Supply and Install CERTAINTEED LANDMARK AR: LIFETIME WARRANTY, 10 YEAR SURE. START PROTECTION, CLASS A FIRE RATED, COPPER/ CERAMIC STONES for a FULL 15YEAR WARRANTY AGAINST ALGAE CONTAMINENT,250 POUND,EXTRA HEAVY WEIGHT, 110 MPH.WIND WARRANTY, CATEGORY H HURRICANE, STORM MURIC_ANE NAILED (6 NAILS PER SHINGLE), MULTI-LAYERED,'LAMINATED ARCHITECTURAL STYLE,FIBERGLASS BASED ASPHALT SHINGLES. COLOR:_ 4.7 V Vr Supply and Install HICK'S VENTED ALUMINUM DRIP EDGE on All of the Dormer Eaves. Supply and Install 8" WHITE ALUMINUM DRIP EDGE on All Other Eaves.. Supply-and Install CERTAINTEED WINTER-GUARD (Ice & Water Shield) WATERPROOF UNDERLAYMENT SYSTEM All of the Areas to be Re-Roofed and Up the Triangle Sides of the Dormers. Supply and Install AIR VENT SHINGLE VENT II RIDGE VENT on the Entire Main Ridge. Supply and Install ALUMINUM & NEOPRENE SOIL PIPE FLASHINGS Remove and Haul Away All of the Old Wood Shingles from Everything that can be seen from Standing at the Front Edge of the Driveway Including the Right Cheek. Supply and Install 16" WHITE CEDAR SQUARED AND RE-CUT CEDAR SHINGLES. Clean and Remove Debris from work area after job is completed. TOTAL INVESTMENT ------------- $ 129000.00 C ITARL, ES . - COREY 11 1 The Roofers Roofer" POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards,Plywood Sheathing,Missing Metal Flashing, Side Walling or Any Other Carpentry Needing Replacement will be done and charged for as an Extra: Materials Plus Labor at the Rate of$ 60.00 per Hour PAYMENT SCHEDULE: A Deposit of One Half is due at the Signing of this Roof Proposal and the. Final Payment for the Balance is Due Immediately Upon Completion. WORK SCHEDULE: All Roof Work is Normally Scheduled for Completion Within 30 Days of Acceptance and Receipt of Deposit providing the Materials are Available. Please Make Checks Payable to: CHARLES COREY CHARLES COREY Warranties the Shingles and Labor for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the First 10 Years and the Shingles your LIFETIME if the shingles becomes defective. CERTAINTEED Warrants the Shingles up to a CATEGORY II HURRICANE-110 MPH WIND WARRANTY. CERTAINTEED Warrants the Shingles to be Algae Resistant for a Full 10 Years. This Proposal May Be Withdrawn By Us If Not Accepted & Deposited Received Within Thirty Days Or Before The Next Price Increase•In Materials. CHARLES COREY carries Workman's Com ens at' n and Public Liability Insurance on the above work DATE OF ACCEPTANCE: f� " ACCEPTED BY: SUBMIT VINCENT VALLE CHA CO HOMEOWNER ROOFING RACTOR THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA AGORQ CERTIFICATE OF LIABILITY INSURANCE of/2��. PRODUCER (SO8)997-6061 FAX (SO8)990-2731 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATi Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE . HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OI 439 State Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELO\' P.O. _Box 79398 N. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC IF INSURED All Cape Exterior Remodeling LLC INSURER/-- Arbella Mutual Ins Co 17000 640 Main Street INSURER B: AEIC Insurance Suite 3 INSURERC: -Hyannis, MA 02601 INSURERD: INSURER E 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. ILTR NS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE MMMD DATE MMID GENERAL LIABILITY 8S00041933 01/14/2011 01/14/2012 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED— PREMISES Ea occurrence $ 100,000 CLAIMS MADE FK OCCUR MED EXP(Any one person) $ S,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ I ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WCCS007896012011 01/14/2011 01/14/2012 X' - AND EMPLOYERS LJABILITY TORY LIMITS ER B �CER/MEMBER PEXC NERJE CUTNEr� E.L EACH ACCIDENT $ 1,000,000 (Mandatory in NH) �� EL.DISEASE-EA EMPLOYEE $ 1,000,000 If be under SPECIAL PROVISIONS below OWNER INCLUDED E.L DISEASE-POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS rel : S08-81S-3099 CERTIFICATE HOLDER,_ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Corey 81 Corey The Roofers IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 1694 Falmouth Road, Ste.115 REPRESENTATIVES. Centerville, MA 02632 AUTHORQEDREPRESENTATIVE 13oanne Bretton ACORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. lI . The ACORD name and logo are registered marks of ACORD ✓he tb"vnaowwea6Ch ol'-Waddac ael& .iu��a��nu�ctt� - vcl.:u uncni u� r uun� �aici. "D.\ Office of Consumer Affairs&Business Regulation Boartl of Buildinu, RC;;ulatiuns'antl Standards HOME IMPROVEMENT CONTRACTOR Construction Supervisor License Registration: :.,1:36066 Type:. Expiration 6/6/2012 Individual License: CS 2881 Restricted to: 00 i CO Y&COREY-HOME-IMPROVEMENTS CHARLES E COREY CHARLES COREY\ �;�;� �� 1694 FALMOUTH RD#115 zit, 1694 FALMOUTH D #115% CENTRERVILLE, MA 02632 CENTERVILLE, MA 62632`°=z: a>'' Undersecretary --�- !f Expiration: 2/14/2012 Commissioner Tr#: 14793 I ��`\ . �� �r e '2 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �, -Map Parcel ;a&e Permit# 30 0 Health Division Sad ° -l:#- : ,20.? Date Issued 03 to M cG tir, �.03-03�- T, Conservation Division �' , D'� y Application Fee Tax Collector Permit Fee 02 91 Treasurer � ICf��ST0B�4II11A Planning Dept. COME M6 pE SEyGE1� Date Definitive Plan Approved by Planning Board CANS SON � �oFROMR 0 Historic-OKH Preservation/Hyannis Project Street Address l aj f­5_'%�Y 14 V-S— 1-fY/4 IAV-!�' Village Owner A C6214?Le V Address / ,Z/ ef S VW13 Telephone Permit Request .-:rXP,4A/P �1�J FXBO/Z AE2P R—.6664 7?—r'A 46EV 61,J A Square feet: 1st floor: existing proposed 2nd floor: existing/Qo proposed D Total newer _ Zoning District Flood Plain Groundwater Overlay Project ValuationS�6 Construction Type W6©,P Lot Size 1 6-ao Selma- Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. t Dwelling Type: Single Family A— Two Family ❑ Multi-Family(#units) Age of Existing Structure �7/ Historic House: ❑Yes No On Old King's Highway: ❑Yes XNo Basement Type: AFull Xrawl ❑Walkout ❑Other r Basement Finished Area(sq.ft.) � � Basement Unfinished Area(sq.ft) /JR c Number of Baths: Full:existing !z,2 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 ONo fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage)Kexisting ❑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# � t Current Use - Proposed Use BUILDER INFORMATION Name_1A i-Ai4 lUD e� lJC�C/�/�- Telephone Number Address P6, J�o License# �J Q �S/WP 4)tc�(r 6141 02-S3;3 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE - DATE 43 FOR OFFICIAL USE ONLY JERIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER , DATE OF INSPECTION: = FOUNDATION FRAME �� INSULATION Q!W S U 8�2��0 3 47 ® A FIREPLACE ELECTRICAL: ROUGH FINAL r , PLUMBING: ROUGH FINAL GAS: ROUGH =:^' FINAL FINAL BUILDING ' DATE CLOSED OUT ASSOCIATION PLAN NO. T �� I The Commonwealth of Massachusetts - Department of Industrial Accidents - office 01110FOsORMANs 600 Washington Street ...... Boston,Mass. 02111 Workers' Compensation Insurance Affidavit i name: A A-D Z. A LI CLA l 2 lowtio: a t 1?0 u 2/ 3 Il P Z-'Gy4dUtit dJ (�� city C�f,�,�O�G�IJfGI-f phone# ❑ I am a homeowner performing all work myself. I am a sole netor and have no one workin i i acity '/,r///%%��%%/%% %%/%%%%%%%%/%%%/%/%%%%%%%//%/ %///����/%/%��%%%%%%///%/%%%%%��/��//%/%%%%%///%%�%/�///�%�%//////%//////%%% ❑ I am an.employer providingX. workers' compensation for my employees working.on this job. :::::::::::::::?::::::::::?::?:::::::::::::::::::: x. M. )mn Y ........... `:.,;h QtY• ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices; t 01ap 8 Y XX :!:\:•.:yu>ii}ij$:!is .:`:s� :,>.<}:!?>�i:�i:%:;ski::?::;:;::iJ::::isS:i:^:s:>::;:;:::;: i`:::;:;:i;:j::. ?i:: ;!:::':: +......?s':cif'i:?is�:;F4'is�{"}<:;`is�':>.T:•.' :;::iii yL?i:;}}:;?i+j?�::`;'.Y:;i: •i:8i'4i':• ...............:...::::::::::::::::::v:::::::::::::.i:-i:v:Piii:4:vi:Jiiiiii:•:�ii:•ii: fviii}iii?:_i:?•i:�:?•iii:???^::i?�is?•:;�;}i:::?•:•Y:h:?•:r i�:??•:iii:??^i:?4::?vi:4iiii:�iiiif:::+::•iiiiiiii:�ii:?•ii};{{?:4:S:L:�iii'""""':.... ....... ............. ....... v.�..:r ... ................. ........................................................... :. :;i:•«Y�S .:i'::`i?':%:?'>:i::}i` i::?:rill::%i':'iiiiii:r:iiiiiiiT:':lilti}::}:<^?:-ii:t::ivjC:'::?i:iii'?i:?•::?r:<+.:....i:•iii:iii:??i?::i:i:i}iii:;i:•iv;isi::;ii:h:i::+?ii::?•ii>ilin3;;::+i:;i{'isS;iii:.....;ii:ij:};i:?:}{:............:...ii:i'::ili;n<Li:ii ...................................:..:.:�:•:..:.::.�:::w::•.:.�:::::.....::::::•.::::::.�::::.�::.:.::.�: o 'c:'t::t$><:::2!::::: i:::;:'::':::j::::::2:'3;::>:i3:::%;:%;r:::;;;:i::`:$:`::`-:%j<>:;.;?.;?`:::•,'•:i:::::•''ri':::::::::f:: ':::: ?y`:i::::::::::;:`:::::2: ::5 :::>-:j::y3:::: �... .......:.:::...:....:..... <?•i\!-ii:??+.?3X:4:?i•i:?4:4iii:'?•i:?triii. ........... ... ....... - - .:.. .. •• .. .. :::.� ...:...::.v' .S.Mwnh•>?iNi?i;ihr vTi ........................�:::.:...........................:v::::.:.....................:............:........v...... •:.�:...........::.:v::::::•::ni; .y:. :: v..... :w:....:.:�::.v:.�:::�•i:•i:?•ii:?•i:y.�?/F:...::: :::i:::!:i:+:::?41ii�i:-i:::•ii::=::[Li?`:•:?^i::.i:lii:?iX.i}J}i'i:': risrairce • .... ;name:::::;�:�:::>::::><:<::;?::;:>::::::»:>:<>;:;:;<•::;::::>::«:<::;:;;::>:;.>:`::Y•::ii ... ......... ........ - c sa :'b bn .......................... ..........:.....::....:...:....:.::...:....:.:........::..............:..........:.....:.::.:.......................:..................... :::::iii::::.:::;:t:>:.::iii:%:t%:::::;>;iii:irr;ii:•i:;#::::.:?:;;::::>;:;`:;;;:-;;::;:::;:::;;;::::;': ;:::;::::::::;:::i:;::::;:E.'.::::::::$.::::;:;::i;::::;;;::;i3.`:`:::�:.. . ............... ........................... ......... .':..� .::..;- R::::;::;;:;::::::>.>.t:ri:ii i::;;:ii;:;%::`;:ii::rill:::;:;ii:::5::::;::::::?:::::::;??::::>.:i::R:;:;::::;2:::iri:;;:::i%::::;:::::;:>:.:: .. ,r;.;:`:':"'. �:?":'':'':"::ir::i::;;::.:`i::i:%'+.:i< Failure to secure coverage as required under Section I5A of MGL 151 can lead to the imposition of criminal penalties of a nne up to s1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Oice of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Date �—3,0 —B Print name d� f C Phone# Zliikil official use only do not write in"area to be completed by city or town official city or town. perndt/license# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selechnen's Office ❑Health Department contact person: Phone 4; - ❑Other Umsad 9/95 PW Information and Instructions "�- Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neitherthe 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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and company names, address and phone numbers along with a certificate of insurance as all affidavits maybe supplying mP Y submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and d'. date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned-- the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of 1nvesdgailons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 r r • r 5 IME lo�ti Town of Barnstable P °* Regulatory Services ' BARNSPABLA ' Thomas F.Geiler,Director KASS ...... prED;9;�A`°� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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: t!'C e £.__led 6- Estimated Cost o 00 Address of Work: /� �/ �S 1 4 U`^8 Owner's Name:1Z:�4� M e6-A 22 Y - I 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 IlVUROVEMENT 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 ontractor Name Registration No. OR Date Owner's Name r RESIDENTIAL BUILDING PEPJvHT FEES APPLICATION FEE New Buildings,Additions $50.00 AlterationsrRenovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEw LIVING SPACE t/ 151q square feet x$96/sq.foot=_ SO x.0031= Q �— plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES (attached&detached) square feet x$32/sq.ft.= x.003 1— ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 - >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS . Open Porch x$30.00= (number) Deck x$30.00= (number) . Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Sw1mming?00l $25.00 Relocation/Moving $150.00 (plus above if applicable) o Permit Fee I Ito CMR Appadix 1 Table dS 1b(continued) Prescriptive Packages for One and Two-Family Residential Buildings Heated witb Fossil Fuel MAXIMUM MINIMUM Glaring Glazing Ceiling Wall Floor Basanaaa Slab Heating/Cooling Area'('/.) U-value= R-value' R-value' R-value' Wall Pesimcwr Equipment EfFciency' R-vaivas R slue Package 5701 to 6500 Heating Degree Days' Q I2% 0.40 38 13 19 10 6 Normal 0SZ 30 I9 19 10 6 Normal 12Y° 85 AFUE g 12% 0.50 38 13 19 10 6 T 15'/. 036 38 13 25 NIA NIA Normal 6 Normal U 15% 0.46 38 19 19 10 V 15% 0.44 38 13 25 N/A N/A 85 AF1JE FUE W 15% 0.52 30 19 19 10 6 i5 X 19% 0.32 38 13 25 NIA N/A Normal y 18% 0.42 38 19 25 NIA N/A Normal Z IS•/. 0.42 38 13 19 10 6 40AFt1E AA !8•/. 0.50 it) 19 19 10 6 WASTE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: .2, Sl 4. %GLAZING AREA(#3 DIVIDED BY 92): 5. SELECT PACKAGE(Q --AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q4orms49 80303 a 780 CMR Appendix J Footnotes to Table A2.1b: lass doors, skylights, and I Glazing area is the ratio of the area of the glazing assemblies (including sliding-g basement windows if located in walls that enclose conditioned space, but excluding opaque doors) to the gross wall area, expressed as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example,3 f of decorative glass may be excluded from a building design with 300 f�of glazing area. 1 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling.R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation.thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry, log)wall constructions,but do not apply to metal-frame construction. S The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 'The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement &-scribed in Note b. "The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. 3 If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest. efficiency must meet or exceed the efficiency required by the selected package, 'For Heating Degree Day requirements of the closest city or town see.Table J5.2.la NOTES: a) Glazing areas and U-values are maximum acceptable levels.Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 e ; P��pZHElo��o Town of Barnstable Regulatory Services BARNSTABLE, = Thomas F.Geiler,Director s6g9 .� Building Division �prED MP'�A Tom Perry, Building Commissioner 200 Main Street, Hyannis,M.A 02601 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 1'91f A(-11 1,9,Z> L57 /Q(-)n4 Q l e_ to act on my behalf, in all matters relative to work authorized by this building permit application for(address of job) Signature of Owner Date JAt Print Name L O CAT 1 nnAN v ■ laIIE- f -. •- JIANWLTLLGE.. ' NOTE:not all symbols will appear on a map j GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES / EDGE OF BRUSH r ORCHARD OR NURSERY V—V—Y—V EDGE OF CONIFEROUS TREES MARSH AREA EDGE OF WATER _ DIRT ROAD ' 1. . DRIVEWAY . l E_—PARKING LOT PAVED ROAD DRAINAGE DITCH "r y PATH/TRAIL n PARCEL LINE ** r NAP110 MAP# 21 E PARCEL NUMBER s186o E HOUSE NUMBER 30 ` f 2 FOOT CONTOUR UNE 10 FOOT CONTOUR LINE 1 Elevation based on NGVD29 j 4.9 SPOT ELEVATION /, e STONE WALL k X— FENCE / e RETAINING WALL 1 21 1-i—i—t- RAIL ROAD TRACK STONE JETTY SWIMMING POOL PORCH/DECK [� 0- BUILDING/STRUCTURE _ H+1- DOCK/PIER Q HYDRANT \ / 6 VANE ® . MANHOLE Io POST p� FLAG POLE - 1 T O W N O IF A R N S T A B L E O E O G R A P H 1 C' 1 N F O R M A T 1 O N S Y S T E M S U N I T p SIGN ® STORM DRAIN ■ PRINTED SM IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representatio DATA SOURCES: Planimehics(man-made features)were interpreted ham 1995 aerial photographs by The James 11=100'smle map and may NOT meet of property boundaries.They are riot true location and W.Sewoll Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE n TOWER W. / 0 )0 20 National Mop Accuracy Standards of this do not represent actual relationships to physical objects Corporation.Planimehics,topography,and vegetation were mapped to meet National Mop Accuracy Standards c 1 INCH 20 FEET* enlarged scale. on the map. ate scale of 1'=100'.Parcel lines were digitized from FY2003 Town of Barnstable Assessofs tax maps. O LIGHT POLE O ELECTRIC BOX F:\dgn\conservation.dgn 05/01/03 09:45:37 AM COMMONWEALTH OF MASSACIiUSETTS , IN REAL ESTATE LIC. REAL ESTATE SALESPERSON ISSUES THIS LICENSE TO + ARMAND J AUCLAIR ` PO BOX 2137 SANDWICH MA 02563-8137' 122573 12/30/04 780682 Fold,Then Detach Along All Perforations �" V F I I d1kE4=O �t License: CONSTRUCTION SUPERVISOR ' Number•'CS 051007 Birthdate 12/30/1t932 ' Expires12/30/2004 Tr.no: 6379 - i Restricted ARMAND J AUCLAIR s 12 CARMAN AVE/PO BOX 2137 ,�,- l SANDWICH, MA 02563,. I Administrator . r i l . ; , .J... ..i. .�... ,.) .-f . R. ice• � ' ; � _ I �,I^ _ � , i � � 7 � � 'K• l� II � � f � I � i at . �t�,. � _`..:�.nM_ .7 _�l'..�.:.-..�.-+ram-....- i .I..r fi��1 •_ r '-..��._ , >IL iis 10-61 - - •+� � G• .. i c..r 9 Y-r C••r't�..i F:r'�:/.; �7:.*yax'.';5.....:_.;._.. ..I c� (. " .� C•rid✓i?-E 1� Go'a�C- is E r•c lU a� i G�.it,14 . �':) c^ w, +"6 'I rc Xl 7 i iU �j— Cr A`S : A Ape, 7 ,d k , k ; - I a i.� , i � I r�� �oa�• � 3� !� v ,���� �4', ,� 1�� i. f �, �;�►� a i rio � � �o fZ�ic�oDE'.(a�G. �Q� I I I t CALE i ------------- lipPAIL iM CO 77 4 1 i ! l ' ! j i IX.!f'NND 1' 1 � I I J I i {II Ii ' �' 1 � fl ' � • _ .......iij i i r — N ( �xr ' 1 _ TA ' ... V�-,q`v/�. 1 A Ca' , • V 1 1 +i-1_�tt tC( F , f C 'L. r t i ' I'l LT `q - i}t1. ,ram n aTsLG�1:c1{1"d; i'tv l 1, ryV' LM1_i. i r.�.;l:uK# i I { IJ V PeA)1 iV 4- L't� C�lx9t j l� i)G t: ,' 1/G r� 1 1 �,1V : VI Ulf ct y D.D l ,a3 / 03 I. t I I ' assessor's Office(1st floor) Map _ D Lot ou Apermit Conservation Office(4th floor) Date Issue Board of Health(3rd floor)(8:30-9:30/'1:00-2:00)1LAf�T r��P;o%�•, p 06 Engineering Dept.,(3rd.floor) House#1 • ,v .. e�ne�a� CONNEMN ' Definitiv Ian Appro by Planning Board 19 > iQ C®NSTRUCI'IOX TOWN OF"BARNSTABLE Building Permit Application Project Street �'S'"'r Y Village .&M AI NI S Owner ,Al v&.- Address /,,z/ S57—rr TelephoneQ ;Permit Request oy"C b .4 5we2> PoFIEP,009,e— ,,4,-. leze ec' AAQ 1'�_'O e_ec to e_S' a Total 1 Story Area(include 1 story*garages&decks) square feet Q _A� n Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ gv�'Ip Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use S'!UGC F 4wc,< y JZ>�e'A4,AJ C, Proposed Use S'o4 we Construction Type u__ Cog.D j uC 2 Commercial Residential _N��S Dwelling Type: Single Family V,� Two Family Multi-Family Age of Existing Structure_"yo e_o v-. og�`D Basement Type: Finished XZ5 .- Historic House Unfinished P'+&?-Y.¢h Old King's Highway ,(J Number of Baths '7 W d No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel`i/,GcJ. D t f-_ Central Air N p Fireplaces Garage: Detached. S Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Ale/19,q Rib tT, p uc- /,.,�9! Telephone Number_ S��- f (�_ �✓o Address 03o k 2/_ 2 License# _e_ /, lZ �' 2Gy1A ALfL, Home Improvement Contractor# 5;4 k)P c ep I C-b4t. z!RiQ. tJZ�—W 3 Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 4eggV owl SIGNATURE DATE BUILDING PERMIT DEN FOR THE FOLLOWING REASON(S) 11 FOR OFFICIAL USE ONLY ` r PERMIT NO. #8810 .- ,, DATE ISSUED July 12, .1995 MAP/PARCEL NO.. 306.200. r• , . t - f�l ;� ADDRESS 121 Estey Avenue i : VILLAGE Hyannis, MA. 02601' OWNER Neil Mc Garry/ Margaret M. McGarr DATE OF INSPECTION: j FOUNDATION FRAME INSULATION FIREPLACE,' ° » ELECTRICAL: ROUGH `"FINAL " ri PLUMBING: R _ .FINAL GAS: R YFINAL " - FINAL BUILDING DATE CLOSED OUT1 : c- i ASSOCIATION PLAN NO. r J 111,0219V 17:02 V617 7 27 7 122 DEPT IND ACCID 0 Jr. ConzanomueaA/L o/ Y1Ja,6Jac1zusettJ ZZ ' .1�aParlmenf o��i�uafria[�cctdsnt� 600. W.I nflon Shi l James'.!.Campbell &Ion, ///aaagwslhi 02f f f Commissioner - Workers' Compensation Insurance Affidavit tQoe�urJpamares) with a principal place of business at: (qLy/sM#Jzla) do hereby certify under the pains and penalties of perjury, that: () I am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company Policy Number % I am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have lured the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Humber P Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number O I am a homeowner performing all the work myself. I understand t=at a copy of dais slternent will be fo v.zrded to the Office of invesdgations of fie DIA for coverage verification and that failure to sect:: coverage=ree iced under Section 25A of MGL 152 can lead to the Imposition of criminal penalties consisting of a fine of up to s 1,500.00 and/or years' imprLecrr„ent as well as cNil penalties in the form cf a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this f day of ��/�; ,S� 19 S Ucensee/Permittee Building Department Licensing Board ' Selectmen Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 ° The Town of Barnstable • a►ttrrsr„a�. NAM tee$ Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner For office use only 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. 4 Type of Work: Address of Work: /,I-( _�y Owner.Name: Date of Permit Application: I herein•certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000 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 SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date ✓, n am ctor name Registration No. OR Date Owner's name COMMONWEALTH ?� DEPARTMENT OF PUBLIC SAFETY ( as®sa« _:toot ONE ASHBORTON PLACE Fsttsto is RA 1dift • OF ,` NssssoAss+ttsStstsNtfpp S BOSTON MASSACHUSETT I ,MA 02108 is 4 Codstsossssf*t LICENSE of tole ItA TION EXPIRATION DATE CONSTR. SUPERVISOR FOR PROTECTION AGAINST Si R�T�/19 96 EFFECTIVE DATE LIC-NO. THEFT, PUT RIGHT THUMB RE ` C I NS 21237 16 ,0 0 5/31 /1 9 94 051007 o PRINT IN APPROPRIATE 1 & 2 FAMILY HOME BOX ON LICENSE. Z ARMAND J AUCLAIR {�. .• _ 12 CARMAN AVE POBX 213' R� � B�INGOP�RATORS SS !1 039-22-0221 € SANDWICH MA 02563 s a M INCLUDHOTO.` PHOTO(BLASTING OPR ONLY) FEE: ' 1 0 0 Q O NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY a ••��.,i•""'_ MAY 13 1994 y. HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER =; DOB: 12/30/193 THIS DOCUMENT MUST BE `' « SIGN NAME 11.2 A80VE SIGI11ETjdRE LINE ¢' CARRIED ON THE PERSON OF IG RE OF THE HOLDER WHEN EN-- <`! O THUMBPRINT GAGEDINTHISOCCUPATION. - - - HONE PROVEMENTCONTRACTOR = Regist a ion LV0V;) � � ARMANU AUCLAI�R � � I ADM1NUWM , ` rr S ND6d C A 2563 � W c r' f` c� I1 / ego Posy j Suo-4T�drV �e�c1 D6R�k�R C£r A,' t r�Q Lau 0. i �'Si ,v SCi=16��' i i �zruergo The Town of Barnstable Department of Health, Safety and Environmental Services BARMABIA Building Division NAM 1659. t�`�� 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: Name: Nei Phone tl: 7? S-7 q? Address: 4140111 yl 1115. N4 village: &r i s fA bi-e Type of Business: fi Re,vt Map/Lot: 30b INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible firm outside the dwelling: there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary horse occupation shall be permitted as of tight subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dweIlingwbich are not customary in residential buMings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no command vehicles related to the Customary Home Occupation,other than one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Oaupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be " included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. 1,the undersign-' have read a ors for my home occupation I am registering. r � Dom, 4 � Applicant: i Homcoc.doc R306 200 . A P P R A I S A L D A T A KEY 216055 MCGARIZY, THOMAS C LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 76, 400 800 99, 100 1 A-COST 176, 300 B-MKT 147, 100 BY 00/ BY /00 C-INCOME PCA=1011 PCS=00 SIZE= 1770 JUST-VAL 176, 300 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 70AC -- TREND EXCEEDS STANDARD NEIGHBORHOOD 70AC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 764001 LAND-MEAN +Oo 1763001 130961 IMPROVED-MEAN -240 200 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 1400] LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R306 200 . P E R M I T [PMT] ACTION [R] CARD [000] KEY 216055 000000001 PERMIT—NO MO YR TYPE VALUE CK—BY MO YR °sCMP NEW/DEMO COMMENT [ ]'[R306 200 . ] LOCI-0-121--- ESTEY AVENUE CTY] 07 TDS] 400 HY KEY] 216055 ----MAILING ADDRESS------- PCA] 1011 PCS] 00 YR] 00 PARENT] 0 MCGARRY, THOMAS C MAP] AREA] 70AC JV] MTG] 9210 MARGARET M MCGARRY SPl] SP21 SP31 121 ESTEY AVE UT11 UT21 . 20 SQ FT] 1770 HYANNIS MA 02601 AYB] 1936 EYB] 1975 OBS] CONST] 0000 LAND 76400 IMP 99100 OTHER 800 ----LEGAL DESCRIPTION---- TRUE MKT 176300 REA CLASSIFIED #LAND 1 76, 400 ASD LND 76400 ASD IMP 99100 ASD OTH 800 #BLDG (S) -CARD-1 1 99, 100 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 800 TAX EXEMPT #PL 121 ESTEY AVE RESIDENT'L 176300 176300 176300 #RR 0508 0076 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE100/00 PRICE] ORB11342/88 AFD] LAST ACTIVITY] 04/17/91 PCR] Y