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HomeMy WebLinkAbout0019 FRANKLIN AVENUE i _ r �, _ - -, '�� �� 1. - _ � Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 6/4/19 lk//z Brian Florence CBO Town of Barnstable Building Division r�lN41 ��19 200 Main St. 8qR Hyannis,MA 02601 �STgBtE RE: Insulation Permit B-19-1767 Dear Mr. Florence: This affidavit is to certify that all work completed for 19 Franklin Avenue,Hyannis has been inspected by a third party Certified Building Performance Institute (BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey �u Town of Barnstable u111i19 e '. Post:This:Card So Tha ble From the Street, Ap rovetl Plans Muww st be Retained on,ob and,this Card IVlust be;Kept , *- BARiJSTA({l�.: P e Posited Until Final Inspection Has Been Made� , FN� �,� � *• � �F.. �u� � •�, Permit �°' ,. Where�aCertificate ufnOccupancy�isxRe�qu�red,such Bu�ldg shall N t be Occup�d�unt�l a Ftnallpect�on,hb�een, ade��, Permit No. B-19-1767 Applicant Name: William McCluskey Approvals Date Issued: 05/29/2019 Current Use: Structure Permit Type: Building-Insulation Residential Expiration Date: 11/29/2019 Foundation: Location: 19 FRANKLIN AVENUE,HYANNIS Map/Lot: 292 035 Zoning District: RB Sheathing: Owner on Record: WALLACE,TYLERffi: Co ra�ctor Name WILLIAM J MCCLUSKEY Framing: 1 Address 19 FRANKLIN AVENUE ' Contractor License�CSSL-102776 2 _ ., y HYANNIS, MA 02601 Est Protect Cost: $3,000.00 Chimney: Description: Add R-30 cellulose,and R-38 fiberglass to the%ttic Air seal the attic Permit Fee: $85.00 plane with expanding foam. General weatherization > Insulation: Fee Paid . $85.00 Project Review Req: � r Final Date �' S/29/2019 � ,% E ,f, Plumbing/Gas 41, A uLL Rough Plumbing: l =' ,,, ' This permit shall be deemed abandoned and invalid unless the work authorized;by'this permit is commenced vviihi, s 1 x months aAe issuanL�. Final Plumbing: All work authorized by this permit shall conform to the approved application andthe approved construction documents forwhich this permit has been granted. All construction,alterations and changes of use of any building and st actures shall be in compliance with the local zoning',by laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access reef or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures bythe Bwldmg and Fire Officials are provided on the permit. Electrical Minimum of Five Call Inspections Required for All Construction Work & 1.Foundation or Footing Service: 2.Sheathing Inspection �. 3.All Fireplaces must be inspected at the throat level before firest flue�lming is,m is ailed„ ,„; Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) 7 Final: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: • 4�`ir+�l}yam s E'nr� Town of Barnstable Building , ss to I ,"..�s"r:."°n'''e>.. 's.<. ..;✓r,.,,,.q as ...Hi,RIP MIW, , ;E.. Post This Card SoThat rt isVis�ble Fromhe�Street Approvedn.Plans Must be`Reta�ned onrJobandrthisCard Must:beKept ; 6 " Posted UntilmFlnal InspeetionsHas Been Made $ y, �` 6 £ 1 Permit ° WheieaCert�ficat Oecu ancy^isRequired,such Bultl�ng-shallNotbe Occupied until a Final Inspection;fias been made zr Permit NO. B-19-1622 Applicant Name: Michael McMahon Approvals ,^ Date Issued: '05/15/2019 Current Use: Structure A Permit Type: Building-Insulation-Residential Expiration Date: 11/15/2019 Foundation: Location: 19 FRANKLIN AVENUE, HYANNIS Map/Lot. 292-035 Zoning District: RB Sheathing: 4-71 Owner on Record: WALLACE,TYLER Contractor Name�MICHAEL T MCMAHON Framing: 1 Contractor License CS 068111 Address: 19 FRANKLIN AVENUE 2 HYANNIS, MA 02601 ,Est ` ote Prct Cost: $3,058.00 Chimney: Description: Weatherization-Cellulose, Fiberglass,door sweeps and h _ Permit Fee: $85.00 . Insulation: weatherstripping Fee Pald $85.00 Project Review Req: Date 5/15/2019 Final: �C Plumbing/Gas Rough Plumbing: ' Official This permit shalt be deemed abandoned and invalid unless the work authonzed by this permit is commenced within six months aafter issuan Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street&'road and shall be maintained open for pub&-msp'eetion for the entire duration of the work until the completion of the same. b Final G F as: a The Certificate of Occupancy will not be issued until all applicable signatures tithe Building and;Fire Officials are;provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: �. 1.Foundation or Footing ' Service: 2.Sheathing Inspection )� 3.All Fireplaces must be inspected at the throat level before firest flu lining is installed Rough: .,. 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Final: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. ' Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (asset forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Lot 52 Franklin Ave . , Hyaanis, Ma . Lisa Rawding N 41.59 H OF Mgs�9c o ho yGN r!I� STEVEN W. W RUMBA 357 1 A fS CO SURVEyO � 6 • 6 • LE AI 1 . ^ 50 pp p!r M.A � � v Scale 1 " =20FT To n ®f B- r ' stable *Permit - °FTHe w Expires 6 from' u e Regulatory, Services,,, Fee, + BARNSTA13 * z MAC Richard V.Scali,Director` 9�a 1639 a`�� 9 ,., Building Di vis'ion , Tom Perry,,CBO,Building Commissioner, ;t - 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 ' - �. Fax: 508-790-6230 EXPRESS PERMIT APPLICATION' -, , RESIDENTIAL ONLY _ Not Valid without Red X-Press Imprint Map/parcel Number 9� Property Address < 1"�4r vi 4v,e_ Residential Value of Work$ //,000'00 Minimum fee of$35.00 for.work under$6000.00 d *s Li �GP Owner's Name&Address ' �tine _ - i_ 1(0 Contractor's Name �rh <�C�e Telephone Number0 „ ... ;. Home Improvement Contractor License#(if applicable) /'7loS70Email:' �G�Z�� �� qr'?@rCa Co"' «' Construction Supervisor's License#(if applicable) C S t�q al 9S f3 ❑Workman's Compensation Insurance Ch one: I am a sole proprietor �,2 2017 "« ❑ I am the Homeowner ,�U 8 ❑ I have Worker's Compensation Insurance T � `R, C}�= BARN Insurance Company Name !� Ct tl Workman's Comp.Policy#" Copy of Insurance Compliance'Certificate must accompany each permit. Permit Request(check box)" w' 4 ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping Going over' existing'layers of roof)' ❑ <` ,.. s e-side � ' 30 -(maximum.35)#of windows 3 ' [+�Replacement Windows/doors/sliders.U-Value , f #of doors r , :Smoke/Carbon Monoxide"detectors 4 floor plans marked with red S and in 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. + r*rNote: Property.Owner must sign Property Owner.Letter of Permission. A copy of the Dome Improvement Contractors License&Construction Supervisors License is Srei ed(/l�e SIGNATURE. `. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313' F. t, f ' c ' $ f The Com mozoveafth,o;f 0-yack"Setfs ---- Dequarertwim of rndusvial Accidents r—� OffCe Of r7Z1xPS�t?fiMJS ' 600 Washington beef Workers' iCompens.-Aiau Tnsuran e Affidavit:BuitdersiConta-ctorsll-Iect-Licians/Phunbers -UpIicant Information Please Print Lp 'bI Name(Budness Organizaaonllndi%-idndl): Address- s lCEty/StateiZlp= /r�l/(i rfonx AV IS A)�40 Phone SO 0 9 '07 ry J 19 Are you an employer?C'hech the appropriate:box.. Type of project(retltared): 1.❑ I am:a employer With. -4. ❑ I am a general contractor and I 6- ❑Ne.w construction loyeea(full atndior part-time)-* have hired:-the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet:. 7_ ❑Remodeling slop and have no employees These:sib-contractois have g:_ ❑Demolition working forme in any capacity- employees and have workers' 9_ ❑Building addition [No W011rs'comp_insurance comp-insurnnml 5. ❑ We are a corporation and its ME]Electrical repairs or additions required_] , 3.❑ I am a homeowner doing all wort offncers_hai�exercised their 11.❑Plumbmgrepairs or additions right of exemption per IVIGL my��:lf:[No workers'comp_ 12_❑Roofrepaiss insurance requuzd_I' c_152,§1(4),and we have no employees_[No worlt:em' 13.5eOther comp_insurance required] "t nY appEcsnt feat check--boa al nmst also filloot the seceoabelm,sbowin-g fhek wo&e&compeussliospolicy informsdoo_ I Hameowners who su omst this affidavit in&cstag they are doin%all wcA and dea hire outsia2 tentrs crors nmst submii a gem afuda^rit ndics-- s2ch Contractors'Etstch�S"ibis box must.sttsc�maddirionsl sheet show*n?tbenam of-a,-. and statewbEther or not thoseeu;r;xl1,^ce enm7oyees. if the suo{oatrsaors have MvIoy-s,tfls}st:srymtride their w orlEys'comp.policyatm her. Z alit all employer that is presiding work-ers'compensation hisrtrarice for rrty�etriployees. Beloty is the policy marl job site inforFrsatiors Insurance Company 14ame: Policy 9 or Self-ins-Iic ExpirationDate: ' Job Site Address: City/State/zip: rich a copy of the workers'eompensation:polic.F declaration.page(showing the policy number.and expiration date). Failure to secure coverage as required under Section 25}L of NfGL c 152 can lead to the imposition.oftriminal penalties of a fine up to S 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 S250.00 a day against the violator_ Be advised that a copy ofthis statement maybe forwarded to the Office of Im-estigations of the DLk for insurance coverage verification. I do Itere-by cerhfy iinder the pains all wattles of perjury.thatthe iriftorrtrariart pra%�ided above is trite all correct $r.2na rrr. Irate: 7 7 Phone.._ Official use only. Do not write in this area,to be c4mpWM by ciiy or tntVrs of fciaL City-or To-w : PerrnitUcense;ff Issuing Authority(circle one): 1.Board of Health ?.Building Department 3.City/To-am Clerk 4.Electrical Inspector 5.Plumbic Inspector 6.Other Contact Person: Phone 9 _. 6 P�OFSHE Tp�M * BARNSTABL E MASS- TOW' 11,of larnstable 9� 039 prFO MP't - . . Regulatory Services Richard V.Scali,Director 'Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us k _ Office: 508-862 4038 Fax: 508-790-6230 y Property Owner Must Complete and Sign This Section If Using A Buil.der . 4 l VJAJAU9' f�C#g(0 , as Owner of the subject propertiy . hereby authorize �SHftN� �/�CN�CD to act on my behalf, .in all matters relative to work authorized by this building permit application for: (Address of Job) G2 .. d 7 / Signature of Owner Date I�o91-UL� CFIe,(U ,f Print Name . If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the _ 4 , reverse side. ' QAWPFILESTORMSIbuilding permit forms�EXPRESS.doc a. , Revised 061313 °. • Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-092958 *' Construction Supervisor SHANE PACHECO X - 81 JASPER ROAD +• "" MARSTONS MILLS MA 02648 --^.� Expiration:. Commissioner 10/17/2017 ♦ '' ��e�pa»vaaorzcuecc�o��aaaac�cwelt�- ' Office o1'Consumer Affairs&Business Regulatiou .License or registration validfer individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: b Registration 176570. Type: Office of Consumer.Affairs and Business Regulation Expiration 973L201'7 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 " e SHANE PACHECO SHANE PACHECO 81 JASPER RD ���w /C-'�. MARSTONS MILLS,MA 02648 Undersecretary. ( Not valid without signature I i YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years]. A business certificate ONLY REGISTERS YOUR NAME in town (which you must do hy.M_G.L.-.it does not give you permission to operate.] You must first obtain the necessary signatures on this form at 200 Main St_, Hyannis. Take the completed,form to the Town Clerk's Office,`1 st FL, 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business law_ Certificate that is required'by . : . • DATE: Fill in please: ... .•. _APPLICANT'S. YOUR NAME/S: 2 �Ct Z BUSINESS YOUR.HOME ADDRESS: h Lr v h,,u UL ,.: SO -z33- OSS:i TELEP HONE ,t # HomeTele hone Number SD - — P Z NAME OF CORPORATION: ,r-c 4 E 2 V- S U I rl 1►� NAME OF NEW BUSINESS_ SgvvA 2 TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES N ADDRESS OF BUSINESS d1 "n 1 i4 OZ,60/MAP/PARCEL NUMBER21Z 7 6� (Assessing].:. "When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the.Information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd_ & Main Street) .t❑ make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. "BUILDING CO 15510 ER' D�F�1�cThis individ al h en ii equirements that pertain to this type of busin�MUeST COMPLY WITH HOME OCCUPATION MJLES AND REGULATIONS. FAILURE TO Au h iz d i ptu e** COMPLY MAY RESULT IN FINES. MMEN S: ' T { 2. BOAR OF ALTd i' cam- �MQ � r I ... ` • This Individual has,bean informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: ------------ 3. CONSUMER AFFAIRS (LICENSING AUTHORITY] This Individual has been informed of,the licensing requirements that pertain to this type of'business. Authorized Signature* COMMENTS: Town of Barnstable ,.regulatory $emus o Richard V.Scali,Director * BAJWSresr�, Building Division v mass. g Tom Perry,Building Commissioner men►gat 200 Main Street,Hyannis;MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: d Permit#: 'HOME OCCUPATION REGISTRATION Date: Name: V l Z Phone#: /508"/ Z 33 OSS �- Address: °I of y) ( Village: Name of Business: 1r0 1 r c a,`Y11 ✓� Type of Business: A1►1�1 "Ot VIS C a 1 Map/Lot �`�/ — V.✓ 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 from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything othei 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 home occupation shall`be permitted as of.night 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 dwelling which are not customary in residential buildings,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. • Ariy 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 are no commercial vehicles related'to the Customary Home Occupation,other than.one van or one pick-up 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 Occupation. • 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 I,the undersigned,have read and,agree with the above restrictions for my home occupation I am registering. r Applicant Date: — —1 Homeoc.doc Rev.103113 r^C�-t-, t-� � -t-�---+--'-+----t--�--{-t'--_I•"r�^.��-. �1�---� --F-�--- -F---t---}- --+- --�-�--1- 1 1 i I I 4-1 1 ( T 1 I I f t 1 ' '-T-T -'�-.---.'-�--1..- _T. -+-f •--I 1�-.-r--r-� .� T..''V 7�"''-�\l f I , �� ► 7 f 1 + I � � I I , 41IL s B7 I I oil I I I ± -(---.-.�---�-- . Ik � k J i 1 i 1 i ' - 4 t HE I H : I i I a t Town of Barnstable *Permit 6 Z 6 Regulatory Services �ees 6 71!ZisyS_d,�m • • Thomas F.Geiler,Director (C- lEn a� ' 6 5 Z012 Building Division' JUL Tom Perry,CBO,' Building Commissioner 200 Main Street,Hyannis,MA 02601 'TOW F 4 WA www.town.barnstable.ma.us e: 862-4038 Fax: 508-790-6230' EXPRESS PERMIT APPLICATION" - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Z 0 3,5 Property Address g let-a Ave P Vii n�i S [Residential Value of Work 3,S(jo-c'o Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 141 Contractor's Name S f)qvw G,GVl2r<, Telephone Number 36q-d qS(o Home Improvement Contractor License#(if applicable) i U N N 40 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: [F'I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must.accompany each permit. Permit Request(check box) [j2/Re-roof(hurricane nailed)(stripping old shingles) A11 construction debris will be taken to C 1ne veil eft ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side #of doors Replacement Windows/doors/sliders.U-Value 3 `e (m ,35)#of windows _ *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 required. ' SIGNATURE: QAWPFILESTORWbuilding permit formsEXPRESS.doc Revised 051811 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Super\isor c License: CS-092958 SHANE PACHE -0 -._ •�� 143 HAYES Irb 7V)2632 CENTERVI1 LE MA n ���` 00 Commissioner Expiration10/17/2013 Office o� onsumer Affays&BJsiness Regulation HOME IMPROVEMENT CONTRACTOR Registration - 164440 Type ; Expiration: 10/672013. Individual i . I S" PACHECO k F SHANE PACHECO e, f r 143 HAYES RD g CENTERVILLE, MA 02632 r Undersecretary j. _.._ I:t , J , License or registrat►on val►d=.for tndividul use only. 1 before the expiration date If found return toulation Office tb Consumer Affaies`and and,, Reg % 10.Park Plaza=Suite 5170 ` Boston,lVlA 02116 i Not val►d w►thout signature £60zami, JauoissivauaoO uoilejOx3 CRI SdAVH£171 • aNdHS I--TIM 896z60-SO :asuaoi� aosi.t.iadnj untl�n.ilsuoJ spiepuels pue suoileInbaH Buippn8;o pjeog AA Aia;eS oijgnd;o luawpedad - sllasnyoessevy ""' The Ccrmmomwabh ofMassackuseft Dqwrtment o,, ladusfiial Accidmft office of lT ry trgations . 600 Washington Street _= Boston,CIA 02121 tvrvk�mi�gov/diu Workers' ompensation Insurance Affidavit Bider-dContracbarsTJk tch c anslPhimbers Applicant Information i Please Print Legibly NameBusmessigaitionlindivi Address:_ City/St3& ip S Gnj wt ck A, oaS 63 Phone i#_ 50 (o Are you an employer?Check the appropriate box: Type of project(required): I 4- am a omtractor and.I I_❑ I am a employer with. ❑mp1oy�ees(frill at dlorport-time).* havehired/fie sub-contractors 6_ []..New construction 2_LO 1 am,a sole gruprietbr orpaaher- 1sted on the attached sheet. 7_ ❑Remodeling These sub-contract�ars have ship and have no employees. $_ 0 Demolition wading for mein any capacity_ employees and have vrorlxrs' [No`vorlcers' comp_ comp=insuranM1 9- ❑Budding addition regitired-] 5. ❑ We area corporation and its 10-0 Electrical repairs or additions officers have exercised/heir 3111 am a homeowner dazing all^uvoric- . 1I_:❑Plumbing repairs or additions myself [No workm'gip. right of exemption per MGL 12..VRoof repairs insurance required_]1 c.152,§1(4X and we have no employees-[No workers' 13 EVOther doo,,L. comp:inst mxz required_] •�+inYapplica tchecksboa#lmast also filloutthesectionbefowshowingth&viodereconjp aply .,L- Homeoam ere whn submit this affiftm iD&catmg'they are doing sH work and then Mire oars&cownamn inu submit anew affidavit indicating such_ (contracture that check this box must attached as additiumal suet showing the name of the sub-cautzaam-iind state whether arnot4wse entities have employees. If the sub coatnaetnrs bave employees,they'must provide their workers'rump.policy number_ I am an employer that is provirlflag workers'congwnsadon insurance for my enrpiny,eax Bdlow is the paltry mad job site, informatiom. Insurance Company Name: Policy#or Self_ins.._Ire_#: Expiration Date: Job Site Address: Cify/StatdZip: 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.imprisonme4 as well as civil penalties in ffie form of a STOP WORK ORD Rand a fine ofup to$250_00 a.day against the violator_ Be:advised that a coley of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby ce fy under thepains andpenabYes ofpeduty that•the informateon;pravi&d abays.is trice and correct $itntature: hiµ c,�e.� Bate Phone# Yb C?Blcial use only. Do not writs in this area,to be coompleted by city or town of iiciaL City or Town: PermitUcense# Issuing Authority(drde one): L.Board of Health 2.Buffing Department 3.City1rown Clerk 4._Electrical Inspector rr.Plumbing Inspector 6.Other. . Contact Person: Phone#: 6 4a BARNSTABLE "�"� 1639. T of Barnstable 9A ��� own arns : Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623 0 Property .Owner Must Cotnplete and Sign This Section If Using A Builder as'Dwner of the subject property hereby authorize ,�►1 G� 2G C, to act on my behalf, in all matters relative to work authorized by this building permit application for: , (Address of Job) 7kk Signature of Owner 041. Date Print Name If Property Owner is applying for permit,.please complete the Homeowners License Exemption Form on the reverse side. Q:\WPMESTORMS\building permit forms\EXPRESS.doC Revised 051811 �t Town of Barnstable Regulatory Services Thomas F.Geiler,Director i639' ��� r 659.,► 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 wbo 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. Fhe undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection )rocedures and requirements and that he/she will comply with said procedures and requirements. i ignature of Homeowner \pproval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code ;ection 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 zom the provisions of this section (Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner :ngages a person(s)for hire to do such work,that such Homeowner shall act ag'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 esults in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot ,roceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is .ltimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the ermit application,that the homeowner,certify that he/she understands the responsibilities of a Supervisor. On.the last page f this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in our community. :\WPFILES\FORMS\building permit formS\E7G'RESS.doc .evised 051811 �"E . The Town of Barnstable , M Department of Health Safety and Environmental Services � `` P Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME OWROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires th�t the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement/, Mmoval, 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: Est.Cost�� Address of Work: --a Owner's Name It g Date of Permit 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 R DEALING EAL_NT WORK DNREGI HAVE TERED CONTRACTORS FOR APPLICABLE HOME 1MP 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 nwnar2c Name A The Commonwealth of 4fassachusetts Department of Industrial Accidents ` office ollnvesUgat/ons _': f'.:..:_r,, 6flll {1'ashin;;Ion Street ` I+.w :� . " Boston,.. A1u.vs. 02111 Workers' Compensation Insurance Affidavit .........._ ..__.,�....r_. .....�_..._......... _.._^., _ - ^' 'e.....`...:.w.+.- ....:air+.-ti..:. ..yrn.;:..�........�... ._...... ....--- A licant information• Please PRINT Ie�` .. ._._.____......._�._.._....»_.... .__...__.. .._....._...._..b..... LTG.._.."__.....__ ......__I.._..-_._._...__._......._._.... name 30 location• /4 �/-�/�'2 L� �I �e --lam citv 01,9-s t4-6D :.C: Phone# ❑ I am a homeowner performing all work myself. I am a sole proprietor and have no one working to any capacity ._.tawn. .+.r•-_env. "7• �*T'�''Kiazcarr�taep'A7?,s!^4m�^n "�`Te.r^^'�°."'!"�1y,�"`�',�"�`w.�:.t�.":.', r'!a+Y". . I am an employer providing workers' compensation for my employees working on this job. company name: ,iddress• city: Phone#: . insurance co. Policy# I am a sole proprietor General contractor homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: com any name• b address U/,✓�i� cih•• one#• e insura cc CO. licy# _.. ..._. .a.:.-:'�1.�.:.,_ _... H�ati_^ems;r.. .-q:q _ ..-e.•>'-r••av�^�,� ���� �� SA _._.....__...__s=. - ..__ ._.:tea• company name, address: cih•: ahone#: insurance co Policy# :Attach additional sheet if rieeessary- t'"..T.r_ i' srr�r,:f __ _r;,.�.._;3'"'":F:^' ..�. .,�, s►t: " y'"�"�"" �" ---_.._ ....___._...__ .:.� .�-- �� — .�. - —��y��_ "--ter_ •,;r.:.ri.;.,: Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one dears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Once of Investigations of the D1A for coverage verification. 1 do herehr ce -under the pains and penalties of perjug that the information provided above is true and correct Si_nature __._Date—: Q R 3 /6 Print name U d t �l tj /" Phone# S� — '� 4' official use only do not write in this area to be completed by city or town official r city or town: permit/liccnse# r'7Building Department E" ❑Licensing Board check if immediate response is required ❑Selectmen's Office ❑ P health Department contact person: phone#; raOther (mised 3,9;P1A) 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 emiploree is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An emplo'Ver is defined as an individual, partnership, association. corporation or other legal entity, or any two or more of the forc-oin�� engaued in a joint enterprise, and including the le-al 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 dwellino house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the `,rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section '_5 also states that even,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. 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 co 4� r nrcompensation ^ It��lsiplPtp�! �Jl `i7n_t_i^,j the box that appilPC tA.,/L1 tIT Cltll ltl(lll., Md f lease fill Ill the •.vo,ke s' affidavit ; . supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents fol- 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. 77 City or'rowns 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 to the Department by mail or FAX unless other arrangements have been made. Tile 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. T.tV The Department's address, telephone and fax number: The Commonwealth Of Massachusetts z..R Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ✓fe Var�arrtontuea� o�✓��Cw�ac o� f DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number:. Expires: Restricted To: 00 JOHN W FINN JR 10 HALYARD CIRCLE MASHPEE, MA 02649 I ..�i4e�oa„yxo�e«al!/�o�..�vaaac%«aetta HONE IMPROVEMENT CONTRACTOR ` ''`Registration 112841 -_ Type INDIVIDUAL Expiration fv-04/29/97 ,'-JOHN A FINN JR JOHN Y. FINN JR DODSON MAY ADMINISTRATOR E FALNOUTH NA 02536 I' TOWN OF BARNSTABLE i-d-s CERTIFICATE OF OCCUPANCY PARCEL ID 292 035 GEOBASE ID 20233 ADDRESS 19 FRANKLIN AVENUE PHONE Hyannis ZIP — LOT 52 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 20104 DESCRIPTION 14 X 16 ADDITION (PMT.017901) PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY i CONTRACTORS: _w Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $.00 Ox CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY * • * BAANSTABM + MASS. OWNER RAWDING, LISA 1619• A�O� ADDRESS 37 NEW LONDON AVE EO MIS MARSTONS MILLS MA BUILD}NG DIVISION BY Gc� J 4 DATE ISSUED 12/23/1996 EXPIRATION DATE ' TOWN C�r BARNSVABLE �. BUILDING :PE IT EIARCEL. ID 292 •035 ` GEOBASE ID 20233 ADDRESS -19,-: tANKU AVENUE PHONE I-lyarin.is;.- ZIP - LOT 52` BLOCK ,LOT SIZE -- DBA - DEVELOPMENT •y DISTRICT HY PERMIT 17901 DESCRIPTION ADD 14 X 16 BEDRM. PERMIT TYPE -BADDI .., TITLE _ BUILDING PERMIT ADDITION CONTRACTORS: FINN, JOM�, W. JR. ;_ Department of Health, Safet3 ARCHITECTS: and Environmental IS i TOTAL FEES: $31.00 �tllEt BOND CONSTRUCTI0000STS $Lf`SY,000.00 434 REBID ADD/ALT/CONY 1.. .` PRIVATE P ABLE. MARS. , OWNER RAWDING; LISA 163o. 1►1 ADDRESS 37r.IEW LONDUN AVE IN ,�I �MASTONS MILLS MA '. . 'Y BY BUILD vjsfo ` DATE-ISSUED 09/16/1996 EXPIRATION DATE i THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,.EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS'DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERM.!-.-MOOES`Mrr RELEAQ -TtIF—ADPUGAi::;7?. N THE CONDITIONS OF-ANY AFr�c�.i�. ,;•;vOfVl6iOt rtc'.l�hr_IC'TiONB: - MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION-WORK: ( APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE PPLICABLE,.SEPARATE THIS CARD KEPT POSTED UNTIL FINAL INSPECTION }1.'FOUNDATIONS OR FOOTINGS PERMITS ARE'-jiEQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE 0 (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHAL 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BE - 4.FINAL INSPECTION BEFORE OCCUPANCY. s I TOE N � F,,,,44 BA . NSTAI BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS i �s:.1 - �,cTX 1 1 a,WIRIN �. �/ .. � x t f =°l P, N BING f 'BUILD l � � :2 (? YJD 2 LL, r.`sL arwFwiLi•? ..W.•. o� A? 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT i. 2 BOARD.OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROBED UNTIL PERMIT WILL BECOME NULL AND VOID IF.CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF`•CONSTRUC- MONTHS--OF DATE THE PERMIT IS ISSUEfD AS TELEPHONE OR WRITTEN NOTIFICA- TION. h, NOTED ABOVE. r^. �01 TION. 0 , `�ptME Tp�� The Town of Barnstable - 9 BARNSTABLE.g Department of Health Safety and Environmental Services MASS. Eo :y Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Py Location l ,1 Permit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: 4 Please call: 508-790-6227 for reeinspection. f�= Inspected by J ajk-��� Date `oF�HE r � The Town of Barnstable o� 9 BARNSTABLE.g Department of Health Safety and Environmental Services MASS. �fOMP�a Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location �Q W'j ' ,.1 ej Permit Number Owner Builder One'notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: t`' '�_ ig i 12-p'W" CIO, �U /k�-0 Please call: 508-790-6227 for reeinspection. Inspected by � - X A �,✓ Date I/ /Engineering Dept. (3rd floor) Map Parcel ©_�,5 Permit# House# � Date Issued 9 t'7 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee �L n Conservation Office 4th floor 8:30-9:30 - Pl ng Dept. �` BARNSTA r��2 MASS: Y i� 16 TOWN OF BARNSTABLE Building Permit Application Cr sect Street Address ` VillageZ41 .�/� Owner I , ,q > ✓ Address 5A"_� Telephone Permit Request B'}i (2 At�:D 1!6 �^w First Floor 42 square feet Second Floor square feet Construction Type A Estimated Project Cost $ ��a Poo Zoning District Flood Plain / � Water Protection Lot Size �, � ('� Grandfathered�`Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes )a No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout Other 5 L x 6 Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing '— New ^�------� No.of Bedrooms: Existing New Total Room Count(not including baths): Existing__5 New First Floor Room Count Heat Type and Fuel: It Gas ❑Oil ❑Electric ❑Other Central Aires / No Fireplaces:Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: El Pool(size)___ ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name W11 //v/`J Telephone Number' Address L2 License# Home Improvement Contractor_# �•l-- 4 I T 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-- SIGNATURE DATE BUILDING PERM NIED FOR THE FOLLO G REASON(S) µ � �P ' - - � �' a 'F •r. �"//rye � �- �, w+� �! . ',. .� �_ _. ,- _ . _ _ �. . �4 ... F � ",; �� _.. � ''tip.. s � �. ... �.. �. .c,4 � � ; ...�� ., ,/ .: .,.. .. .. � . �11 1.-- � '> � ,. '� � ? _ "� b., � � 1, � i . i 1 N S � � � � � + 1 e i _ . .n i r , .r ..s � .. � , r C� a _. ..xl. � �. iA PQ I RAM .!.` tom, �J ��� I�ma`s.` � � ! • ,� ♦ � �;,t� r •:`.tea I � •� �: � / \'� • �� fir♦ � � ,_ . / � �� � + ��+�r�' � tea► �� + / � � ' / 1, q��'� ter► �► � � . � 0 �'r �' / ,�/► :ter !�� � ,� `� r +`r -.�=•� ,� moo., � .O � �`,= /� cr. .o v,., it 1`.1' � w��• ' �,'`i'�1,r � � '�.+I � � '�,��d • a.,,.,.�,. +�� � ` Ate` `�?i' , �