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Home My WebLink About0036 FOURTH AVENUE (HYANNIS) �(0 1CoCA TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Me,p f �`�� Parcel' t L` Permit# V _ Helth Division Date Issued Conservation Division L F04 Tax Collector Treasurer /d5 Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address ctw0 Village 1 6-wc— .Owner ��' �� Address (2Z wjs& Telephone-- Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new •Valuation 7,C 00, CIO Zoning District Flood Plain Groundwater Overlay Construction Type Wo�� Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family >i( Two Family ❑ Multi-Family(#units) Age of Existing Structure kT-Lk Historic House: ❑Yes Flo On Old King's Highway: ❑Yes N440 Basement Type: ❑ Full VCrawl ❑Walkout ❑Other r 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 C4nt c Heat Type and Fuel: I Gas ❑Oil ❑ Electric ❑Other t -- Central Air: Q9 Yes ❑No Fireplaces: Existing % New Existing wood/coa tove: O Yes No Detached garage:❑existing El new size Pool:❑existing O new size Barn:❑exi ting ❑o w s ze CD Attached garage:❑existing ❑new size Shed:N existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial. O Yes %No If yes, site plan review# Current Use 61-t) htr"Z , Proposed Use r BUILDER INFORMATION Name g 4) ,�Telephone Number f Address di d1en 1J). 8,,w1:546n YWA License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,-,SIGNATURE / R __z7v-,4A DATE 7/X/0.a FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. 1 ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL F GAS: ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT r ASSOCIATION PLAN NO. 4 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 Lep-M Name (Business/organization/Individual): �T_ o ha ct �Rp C ar afi, 6 -Q l B'a o k 1 AA 11r,"d_017 %fyf'. 36 rou l%H7 0qve Address: 15 11)- City/State/Zip: Phone #: /q/a Are you an employer?Check the appropriate boa: Type of project(required): 1.❑ 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 Farther- listed on the attached sheet ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. ` workers' comp. insurance. 9. ❑ Building addition o workers' comp. insurance 5. ❑ We are a corporation and its [N 10.❑ Electrical repairs or additions required.] officers have exercised their 3. 1 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.® Other A)&Q ref)C_ 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 subcontractors and their workers'comp.4mlicyinforanation.-_ -- 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. l I do here4certuder the pains and enalties of perjury that the information provided above is true and correctSi ature Dater rl �.5 Phone#: 690 p i)hn 54e/mvk 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 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 Wd iited -be an=employer•" MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to 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 he application for the permit or license is being requested, not the Department of be returned to the city or town that t 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 lob marked licenses�A new affidavitust be filled oe city or town may be provided ut each applicant as proof that a valid affidavit is on file for future p. year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia �p1HE 1p� 'Town of Barnstable Regulatory Services MAM Thomas F.Geiler,Director �Eo �a Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 W W W.town.b arnstable.ma.us 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. �, c Type of Work: 7 0/�ee-M4t) ' Fen r-e Estimated Cost Address of Work: �`� r'�GCa' ! le-nu el yY!„ a1)1 i5P6r� Owner's Name: '7)rLhDrfdJ'1 delma Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 OBuilding not owner-occupied MOwner 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 Name Registration No. OR v5 Date Owner's Name Q:fbn=:homeaffidav Town of Barnstable Regulatory Services " Thomas F.Geller,Director snxrrsTABM ""9. 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: 17 JOB LOCATION; Ca Yd ✓�/�u� �r> /��-1Qnn�S A�r� number street V vi age / "HOMEOWNER":-D,,_;bQrcZh 6&lmek (!5"6f3 5-._2g6, 5Oeq name home pbone# work phone# CURRENT MAILING ADDRESS: I a a 6 !a_./1�1.O n ce7r"re e4 1d 60Uln4-/ Yy1A D�583 city/tow state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the buildine permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requir meats. D Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of Ws/ber 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 r -- ( , i I E i ` , c r } - I' i t I I I � : .I i i I I I 7 �'U v t�� I/�"-- '�' e?�. 1 �� ►.8,/v v-- i I P N- i 1 I i 1 I I I i - 7 . w : I I I l 1 .. ._ .. 1... ... i I. i : , r • A I , r� ,TNETo�°� TOWN OF BARNSTABLE Z BARNSTABLE, i 9 BUILDING INSPECTOR ,e0 MAI a' r � APPLICATION FOR PERMIT TO �- ............................................................................................................................. TYPEOF CONSTRUCTION ........... v..................................................................................................................... ................................ 192.2 TO THE INSPECTOR OF BUILDINGS: x°--The undersig ned'Hereby applies for a permit according to the following information: / Location ............................................................... :'...4 ................. `. . .. .. ..... Proposed Use ..... -...................................................................................................................................... ' ZoningDistrict ..................................................... ..................Fire District ......................................P.................................... ' Address ... �. �0�1C'eav 4i'2�� Name of Owner ......�...:�'�::"t�':?...................."'� v� "e.l. C1'f w _. Name of Builder ........... !...??1....:....�1............P.�......................Address .....i5.��..... ^'.` ...................................... Nameof Architect ...............................--................................Address .................................................................................... Number of Rooms ..................................................................Foundation ............. ? ..... ........................................... Exterior ....................................................................................Roofing .......................:...` ................................................ .......................................... Floors rti�" Interior ........... .................v..-u-f.........`.."`.::'' ........................... Heatingyk� Plumbing LL V-,P-_ ......................... .................. ...................................................... Fireplace Luf'-� ��._ uV ................................................................Approximate Cost .......�.......................................................... Difinitive Plan Approved by Planning Board --------------------------------19-------- . Diagram of Lot and Building with Dimensions --I -JI L oJ, OCR H <C = Z � d �L-L W LL- LIJ � p C) �;>- 00 re W = w� o: cn � LyU Qd 0Q J zZ CL z.� � � dh� ul IL � tY (n C� _ U I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .../1.6 ... . ....... ................................................ Sigel, Vivian B. st O `. ` . Permit for add to frameNo — ................... � ` w ----�F�V��---- � Locatw _.4tJz..��e�.�.&. -__ ort.................. . ................................. Owner ............... ..£._Si.gmI................. ` W � � [ Type of Construction �� - ' � --.� -------. -----^---'--'--------------'' ( � � Plot ............................ Lot ................................ � � } ^ ' Permit Granted ........Maurcb..I7......... ...lg 70 � ( � Date of Inspection ------------lg - m�' �� ^ /L � /� // | Date Completed ..�v�� ,—��----lg ,r -- .�� / / `, T � �by } PERMIT REFUSED .----..---------------.. 19 � -------------------------~' ` . —.---'-------------'--------' . v -.--.-----.-----.----,--.---.~, ^------''-----------^'—^-----' ! Approved ' lg � ~— r------------'' --------------------------. ' - ----------~--------------... .. | / | ' } / ^| Assessor's map and lot number OF THE THE TO Sewage Permit number ... LE, Housenumber ......................................................................... TOWN OF B A R N S �,MVjft cooeAft %#VVIV me _. ULAftjjj BUILDING INSPECTOR APPLICATION FOR PERMIT TO .............. )(Aa ........ .... ...... ......... ............................................. TYPE OF CONSTRUCTION ................. .................................. ................................ ........0,4v ............I....... ..... N TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to` following information: Location ....... ..... 2............?%e7*........ .........:...................... ................ ProposedUse .............. .......I...................................................................................... ......................... Zoning District ................. .........................................................Fire District ...........&r- -- .................................. V ....... Address��.•..'�l�O�d../.C..........w....................... .. Name of Owner ......................A ........6....................... Name of Builder .... .e. 4, /-/,, ................................................................Address .......... ..................................... ..Address ................................................................................. ..Name of Architect .................................................................. Number of Rooms ......................../ ..........................................Foundation ... ......1314.�5 .................. Exterior ......... ,/ ...Roofing ......... ................................... Floors ........ ................................................interior S:'. ...roVIVe ....... ....................... Heating ...... ......................................Plumbing ...................... ..............:......................... Fireplace ......................WO.........:..........................................Approximate Cost .............. Y19 0 ACW .......... ......................0 **...W.1—****-- Definitive Plan Approved by Planning Board --------------------------------19--------- Area ....li� .................. ), Diagram of Lot and Building with Dimensions Fee ............4// .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH o ETA Al y e, I hereby agree to conform to all the Rules and Regulations of th.e Town ofT..,B,.arnst--bDl,.e re.garding the above construction. ..... . ... No ........... ..................... .. ..... .. ............................... ' Sigel, Vivian R No 21263 . Permit for ...........add to dwelling .....................`. .............................................. Location ..Fourth Avenue ....... .......................................... West Hvann sport ........... Owner Vivian Sigel........................ .. ... .. Type of Construction ................ rame r s ............................................................................... Plot ..:......................... Lot ................................ Permit Granted .......... �'..... ..................19 79 Date of Inspection ....................................19 �o Date Completed ......................................19 ;.. . PERMIT REFUSED ...............'. ....... . ................................ 19 .... ... ............................................ ............ .., ..... .......................................... a c�............ ......................... ............. 4.5 Approve . ...... . .......................... 19 ............. . .......................................... Assessors ma and I . i p of number ....7 �!....1�� 7HE� I Sewage Permit number .... :41A�,.�. .C.. l l = BA"STADLE, i House number MARL r �p 039. 00 } TOWN OF BARNSTABLE BUILDING INSPECTOR ,r APPLICATION FOR PERMIT TO ,�rr..`�''``°' t `' '"s' � x �` _....................................................................................... TYPE OF CONSTRUCTION �211 , > ` t i . / 1l a ..............................i...r.. ........................................................................ _ ......................... ........f....`. . +�........................19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........7 .........`.y............... . ............ .............`...................................`...f............�... .......................................................` ProposedUse ............. .. .................E.............:................................. ................................................................................... w Zoning District .............................................Fire District ......."-.......t .. ........ ............................... Name of Owner V P r°? `' ,;,� /,: ..............Address ".:!�.?..".ji ...., ..�.. .� . + y}w•' �1 ., ..::.......... .................... ........... ................ ,. ........... .... ......... .. ............. Name of Builder .... `'..., ....:..' . . °::.^;`...................Address ............~1. ... .:. ................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ... '.......................................Foundation Exterior ................ ....................................................................Roofing ........... .... :. :..: :':.r'........................................ Floorsa ' ................ ..Interior............................................ . .:r! ........................................lt� y: ....... Heating ........................ �:'..:`.tr... Plumbing ............f�.......... `..�! ................................................ Fireplace .. A`�' Approximate Cost ........ {=' .. .. .... ..., ................... .. .... ..... ....... Definitive Plan Approved by Planning Board ________________________________19________ . Area , ....:<::f................ Diagram of Lot and Building with Dimensions ..4.......................... Fee "?`f SUBJECT TO APPROVAL OF BOARD OF HEALTH in1! 1 I hereby agree--to conform to all the RGles and Regulations of the Town of Barnstable regarding the above construction. Name ............................................. ......................... Sigel, Vivian,, . -A=246-111 No 21263...... Permit for add...to-dwellin2.. ...... .... ................. .................V. ......................................... Location -4i4:-Fourth Avenue ........................................... .................... West Hyannisport ....................................... ...................................... Sigel a Owner ................................Vivian Si..e............................... Type of Construction ....................... frame................... .............................................. ................................ Plot ............................ L ..... ...... y 2 79 Permit Granted .......... .............................19 Date of Inspection ... ................................19 Date Completed ................ .....................19 ..........................PERMIT. .EFUSED ......... —... ...................... 19 ................................................. . .. ... / ....... ................ .... . .. ........ .... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... r i fF J•' Y s { `� 4 f \ j 000 414 - , 10 8- VU - 44Wi s .: i. T f S c A i lly'' �- I s� J .e �j 777 M04TO,q T