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HomeMy WebLinkAbout0082 FOREST STREET i I R-� �s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mi) } Parcel _Permit# Heath Division 53 °I—/G I Date Issued �� Y a Conservation Division Application Fee Tax Collector Permit Fee T �V SEPTIC SYSTEM reasurer INSTALLED IN COMPLIANCE-, Planning Dept. WITH TITLE S FMIRONMENTAL C®CE ANi Date Definitive Plan Approved by Planning Board TOWN REG L. TIONS Historic-OKH Preservation/Hyannis cot 4 New S a Project Street Address oo( e(t= 5T J �• Village Owner �l/J/� % 7- ki�hadP_ '&2e04 ddress Telephone — - O Ro &Q ' © C Permit Request 1.40�>E L— �OO R IvE (k) !J 7—,eT(-D Square feet: 1 st floor: existing /' proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation "il'tonstruction Type Lot Size Grandfathered: ❑Yes . ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family '�5(_/ Two Family ❑ Multi-Family(#units) Age of Existing Structure J Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No Basement Type: UFull + Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing t 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: 4Gas ❑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 O new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use �,. Proposed Use BUILDER INFORMATION Name Telephone Number Address fD License# Home Improvement Contractor# Worker's Compensation#e w ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU �--= DATE G FOR OFFICIAL USE ONLY PERMIT-NO. ' DATE JSSUED K MAP/PARCEL. NO. ADDRESS- VILLAGE - OWNER DATE OF INSPECTION: FOUNDATION FRAME D/ !y/B 3 sa, r i r INSULATION FIREPLACE k ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r a The Commonwealth of Massachusetts —= Department of Industrial Accidents ` ` ''= � — - ti Off/ce of/oresti9atioos 600 Washington Street Boston,Mass. 02111 -� Workers' Coin ensation Insurance Affidavit name: ' 74 �j location A 0Ir T "S T city j Yq �4 ✓u{�;\Do e.T— phone# I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one worldn in capacity %/%��%......%%/%%/G%%%%�O%%�0��%�O/%%%/G%//% %%//////G%%/%%%��//%%%/��%%%% ❑ I am an em I roviding workers' compensation for my employees rwarldng on this job. 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I do hereby certify under the pains and nalties of perjury that the information provided above is t .and correct t Si Date gnature Print name N I C �-� _1 C �fft IU N A-Il� Phone# official use only do not write in this area to be completed by city or town official city or town. - peiadt/license it ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department, contactpenon: Phoned; ' ❑Other O viud 9195 PJnl 1 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 it tooperate a business or to construct buildings in the commonwealth for any applicant who has permit Additionally,neither the om compliance a required.ce with the insurance covers not produced acceptable evidence of c p g 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 supplying company names,`address and phone numbers along with a certificate of insurance as all affidavits 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' corpensation 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/ticense number which will be used as a reference number. The affidavits may be retained to 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. hesitate give us call. please do not to gN a 'The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Depa rtment of Industrial Accidents Office of Investlgations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 1 F ' Er � Town of Barnstable Regulatory Services BAMMM aBM ' Thomas F.Geiler,Director v MAS& �ATE1 59.GMP'ta Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-623.0 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: �i�d E� r 0 U Estimated Cost / l� YY� Address of Work: zoo /� T Owner's Name: •M;C 1 ail e— 7— IV,f, /'f MY ��� U Al f Date of Application: T, 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 EVIPROVEMENT WORK DO NOT HAVE Y ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A: + SIGNED UNDER PENALTIES OF PERJURY I hereby apply fora permit as the agent of the owner: . Date S Contractor Name Registration No. Date Owner's Name a Q:forms:homeaffdav i Town of Barnstable CF tHE T� Regulatory Services BASIMASIX : Thomas F.Geller,Director _ MASS. 9�A 05 ,•� Building Division tED MAC► . Tom Perry,Building Commissioner 200 Main Street,`Hyannis,MA 02601 )ffice: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ® 6 C I�-O VJ�� I Ow JOB LOCATION:. ✓ v ��I l , 1 S / C� I 1 number h I street village . 1i /V name home ph work phone# CURRENT MAILING ADDRESS: Jam' res ong / 00? 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 ' Persons)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. i The=undersigned"homeowner"certifies that he/she understands the Town.of Barnstable Building Department... minirmun inspection procedures and requirements and that he/she will comply with said procedures and requirements. Sigtiafiiievof Homeowner r Approval of Building Official " Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Coda 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 S ervisors o 'de vt that if e d the homeowner engages a on s hire do such( g person(s)for her to_ uP ) Pr gag )P � . 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 ladk 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. , PCP IOU 1-5� JQ_ _ I � Co. r I G I i— 0 6 _ r i ffi 4 � � � � � i � I 4 FF h - I � t I I � i ` t :. 4 1 � - f �, ! f. � � � � � I - I 4 E t` ! _�_ I �� � � _ �. ( i '. I f E � � -�� f f � ' � ; � � � ,:. � r e-�----..L. .� r ......_ � .: � t � . ._ i � . � � �. � T . . � . .: � � ,; � � . f . .__ �_ _ �. .._...- ---- ---.. _. . .. .._ _ . . I ._ . � � � ' � . }, r I � ► Assessor's Office(1st floor) Map C, ` Lot b (A Perit# Conservation Office(4th floor) PDate Issued )(Board of Health(3rd floor)(8:30-9:30/1:00-2:00) 10 t ee -7Se,0 Engineering Dept.(3rd floor) House#� b C7 , j 5r4p-nC SyST ST BE Planning Dept.(1st floor/School Admin. Bldg.) IMULLED I �%SCE M��• NTH initive Plan Approved by Planning Board 19 N , E __ �o - TOWN OF;BARNSTABLE ' Building Permit Application Street Address Village Div Owner Address Telephone 3 �� 2 oFt 7 `7 3 O Permit Request GG Total 1 Story Area(include 1 story garages&decks) square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Projeci Cost $ l 7e da ,4' Zoning District Flood Plain Water Protection Lot Size Grandfathered? Zoning Board of Appeals Authorization - Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number YA,:� 6;�5/ !j Address License# Home Improvement Contractor## /0 d 7 O 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 SIGNATURE4144, DATE BUILDING PERMIT DE IED F E F LOWINASON(S) � I FOR OFFICIAL USE ONLY PERMIT NO. 9242 DATE ISSUED MAP/PARCEL NO. 245 110 ADDRESS 82 Forest Street VILLAGE W. Hyannisport Franklin H. & Dorothy M. Hopkins OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: �ROUGH FINAL PLUMBING: f-''= f-ROUGH FINAL GAS: d R(5UGH FINAL s FILIAL BUILDING DATE CLOSED,OUT` ASSOCIATION-PLAIN NO. 11/02'94 IT:02 V61T7277122 DEPT IND ACCID wo �;; Co rtunoiuuaalt�li o/ Ma4.dachu4e ,l 600 �ainytoz.St�+a� .James J.Campbell &ton, V"udwi fi 02111 : Commissioner Workers' Compensation Insurance Affidavit 1. cazz c with a principal place of business at: ' 10A`74 IL do hereby certify under the pains and penalties of perjury, that: q I am an employer provic0mg workers' compensation coverage for my employees workin this job. ;T: TT F,,j / o� Insurance Companf Policy Number O I am a sole proprietor and have no one-worsting for me in any capauty. O I am a sole proprietor, general contractor or homeowner (circle one) and have fired tf contractors 1'tsted below who have the following workers' compensation policies: Contractor � � � - Insurance Company/POGcy Num Contractor Insurance Company/Policy Mum, Contractor Insurance CompanylPolicy Num O I am a homeowner performing aII the work myself. I t nd�r<_nne that a cot"r of this smote-nent will be fwwarded to the Office of h VC3ti�atzons of its 01A for COYff2ge verfacntion and that failure COMw3ge s r=,.;.,ed under Section 2SA of MGL 152 can lead to the imposition of criminal penatda Cottsisdae Of a tine of up to S 1,500.00 yeas'impriso-rent as well as cMi penalties in the form of a STOP WORK ORDER:nd a fine of S 100.00 a day apinst me. Signed this s� day of Gcensee/Pennittee Building Department Licensing Board Selectmen 01rice Health Department - -- -- -------- - ------ —_ . . -."OF AOnn YQn? AAA An ant 37 F • , � V/7i�i V��l��ri//W7�1v.•va"'�'' ��.���'V4�.fIVWNIiitiVGYW I _ . y - : HOME IMPROVEMENT CONTRACTORS REGISTRATION I oard of Building Regulations and Standards I I One Ashburton Place — Room .1301 Boston, Massachusetts 021.08 1 - . ` HOME IMPROVEMENT CONTRACTOR Tt -Registration 100740 Expiration 06/23/96 Type — PRIVATE CORPORATION -HONE INPROVENENT CONTRACTOR. I ;S"Istfstioe 400140 T Type -'..PRIVATE CORPORATION.. Capizzi Home -Improvement, Inc. j -UpiT�tion 46/13/9 as 'Ca izzi Sr . ` Thom P I 1645 Newton Rd . I Ceplizi Hose UPre-V11"At, Inc . I t , Cotu i t MA 02635 j Thoeee Capful Sr. (�ceMaoW f±L" Nevton Ad. •Cotuit NA 42635 GQaeoo�ueeQ's r . Restricted fo: 10 1EPARTNENT Ir PUBLIC SAFETT CONSTRUCHOR SUPERVISOR LICENSE 10 - loaf lubeo . .Expires: lirtldete: I lA - Weary oily CS 141111 10/21/1116 10/21/1148 16 - 18 2 FuilT Noun lestricted Tr• 00 TiAVI1 N IEBB 100 PLUM NOTION RO ! E HLNOUTH. RA 11S36 . The Town of Barnstable, , NAM• e�rrsrw� • Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 0260I, Office: 508-790-6227 h Ralph Cmssea Fax: 508 775-3344 Building Commis: For office use only Permit A . Date AFFIDAVIT , HOME DWROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERNIIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,.rqw,modecaization,conversion, improvement, m racn-4 demolition, or construction of an addition to any prey= s owner occupied building contatmag at least one but not more than four dwelling units or to which am alb to such residence or building be done by registered contractors,with certain exceptions, along with other Type of Wo Address of Work: :- lam .J Owner.Name- 214 Date of Permit Application: I herein,certify that: - f Registration is not required for the follov%ing reason(s): Work excluded by law. Job under S1,000 Building not owner-occupied Owner pulling own permit Notice is hereby gi♦*that OWNERS PULLING EIR OWN PERMIT OR DEALING WITH UNREGIS'TERID CONTRACTORS TH FOR APPLICABLE HOME -IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A t -'SIGNED UNDER PENALTIES OF PERJURY . permit as thr agent of the owner. . I hcrcby apply,fora Pe g - _ JContractor name ° kv No. ie OR . Date Owner's name �wAssessor's Offiice(1st floor) Man 145 Lot 1 Permit#.- Conservation Office Oth floor Date Issued c r , Board of Health Ord floor Engineering Dept. Ord floor) House# Planning Dept. (1st floor/School Admin.Bldg.): s „�„��� t uA. Definitive Plan Approved by Planning Board 19 (Applications 8:30-9:30 a.m.& 1:00-2:00 .m. TOWN OF BARNSTABLE Building Permit Application Proiect Street Address Village Fire District Owner A.7 i✓ Address d Telephone O - 3,TZ-6 — - 74,e® Permit Request �CJ,��' ff�' /s+/.Sr�Z,� �i i�J//L�J/Y� �i�/Al /J?yw 9 ;&ax, ;,z- Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of ADneals Authorization Recorded Current Use Proposed Use Construction Tyne Eaistinp-Information Dwelling Type: Single Family Two family Multi-family Age of structure Basement bN Historic House 0 Finished Old King sHighway /tla Unfinished Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name 2i //' ��' � Telephone number y2 g- Address/� S"/�fGTI1c(9/ /�i� �rr , r License# .—, 7 ,�i Home Improvement Contractor# l4D 7 546 Z 7-7-14f)' Worker's Compensation # �IJ4- /3/8R Bv--B 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 Pro iectCost / 00e) Fee J o DATE SIGNATURE Or BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T _ #9478 FOR OFFICE USE ONLY 245. 110 - ADDRESS 82 Forest Street VII.LAGE- W.,_Hyannisport, MA OWNER Franklin H. ;& Dorothy M. Hopkins' : . DATE OF INSPECTION: FOUNDATION ; FRAME ' INSULATION , FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL ` FINAL BUILDING: , DATE CLOSED OUT: ' ASSOCIATE PLAN NO. Comnwinive'a.44:o ftwacku�et � eLJe 'artment o1.�` Ltria[J` C,1iL b r, 600 1/Vaskiytoa Street James J.Campbell 6,0etoa, ///amacAu3etb 02f/ 1 •Commissioner Workers' Compensation Insurance Affidavit - censee/permictee) with a principal place of business at: G� (Gty/Snte/Zip) do hereby certify under the pains and penalties of perjury, that: (y� 1 am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company Policy Number O 1 am a sole proprietor and have no one working for me in any capacity. O 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed be low low who have the following workers_ compensation policies: Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor O I am a homeowner performing all .the work myself. 1 understand that a copy of utiis statement will be forwarded to the Office of Investigations of the DIA for coverage verification and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up to 51,5oo.00 and/or ene years'imprisonment as well as civil penalue3 in the form of a STOP WORK ORDER and a fine of S J00.00 a day against me. 'Signed this 1/1 day°of g5'r'I.5'0 , 19 - lf� ' Licensee/ ermittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 4091 375 • The Town of Barnstable snrwsrABM �e� Department of Health Safety and Environmental Services 116 39. 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. Type of Work: 16�fevvz—' Est.Cost I g ®� �� - Address of Work: e92 Owner Name:,�:�� Date of Permit Application: I hereby certifv that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000 Building not owneroccupied 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 Contractor nafine Registration No. OR Date Owner's name