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HomeMy WebLinkAbout0011 GREENWOOD AVENUE 1 '� . Town of BarnstableBuilding ' e Post This?Card So That rt�sV�s�ble FromtFeStreet ?A roved,Plans Must lie'Retamedon Job and this Card Must-be Kept ,tAItNf3t'wBl.6, ;., , r p 6 Posted UntIl.Final Inspection HasBeen`Made � s k` *� +° Wherea�Cert�ficate of Occu ane. is Re"iaired;suchBuildtn shall Not bye Occupied.unt�l a Final Inspection;has,been made i el jm ijii Permit No. B-201-504 Applicant Name: ALESSANDRO LOPES Approvals Date Issued: 02/20/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 08/20/2020 1Foundation: Location: 11 GREENWOOD AVENUE, HYANNIS Map/Lot: 289-093 003 Zoning District: RB Sheathing: Owner on Record: BOOTH;CRAIG A ;" Contractor Name ALESSANDRO H LOPES Framing: 1 k Contractor License: CS.095996 2 Address: 11 GREENWOOD AVENUE , , HYANNIS, MA 02601 Est Oroj6ct Cost: $5,600.00 Chimney: Description: roof replacement ` Permit Fee: . $35.00 Insulation: Project:Review Req: ;` Fee Paid $35.00 ' Date z' 2/20/2020 Final: } Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized,by this permit is commenced withui six months after;issuance. All work authorized by this permit shall conform to the approved application and theapproved construction documents for which"this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structuresshall be in compliance with the local zon ng byelaw and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. r p X Electrical The Certificate of Occupancy will not be issued until all applicable signat res y the Building and Fire Off ials areprovided n this permit. Minimum of Five Call Inspections Required for All Construction Work . Service: ` � 1.Foundation or Footing Rough: 2.Sheathing Inspection „ ; ;, � 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation _ 7.Final Inspection before Occupancy Low Voltage Final Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). ,Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT DO —soApplication number a................... ..... .I Fee ............................................................................. BARN NAM Building Inspectors Initials....................................... t639. BUILDING DEPT. Date Issued..................... ................... FEB 19 NN Map/Parcel........... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHEFJZATION PROPERTY INFORMATION Address of Project: /1 AAJ . NUMBER STREET VILLAGE Owner's Name: C4.4c, K-aJ. Phone Number - v4 4 r9ol SCANN D - Email Address: Cell Phone Number FE"20 Project costs Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize t4 le ssw-,a" Lo to make application for a building permit in accordance with 780 CNM Owner Signature: Date: 02-) 1-712a2,0 TYPE OF WORK E-1 Siding ED Windows(no header change) # Insulation/Weatherization El Doors (no header change) # .' , Commercial Doors require an inspector's review � Roof(not applying more than I layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name ASSAj aAlo Home Improvement Contractors Registration(if applicable)#_ (attach copy) Construction Supervisor's License# cs -0,?cic:l6 (attach copy) Email of Contractor6?m Cccl- J-P 00' Phone number -7,74-,06 7 All PRnPFRTiFq THAT 4A VF cTw iry iRFc nVFR 79 VFA RC tu n t)R IF TmF v iR wrT PRnPJrRTV iq tov APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:34pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules.and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. y Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registratiom, Expiration 184114: 12/16/2021 ALESSANDRO LOPES ALESSANDRO LOPES 9 TIMBER WAY � CL(�aGf�si SANDILVICM,MA 02563 Undersecretary Commonwealth of Massachusetts Division of Professional Licensure " Board of Building Regulations and Standards ` Coristrua4, �t pecvisor ,:. CS-095996 Empires: 05/09/2020 ALESSANDRO H LOPES 9-TIMBER WAY; ` g SANDWICH MA 02563'` Commissioner The Cool mo7tiv,,aldiafMassa�iirsetts IYeparaffLurt crfrndrssftialAccideFdtg ' - - QCe ormestigatEans { . . 600 Was,6irrgtou Street _ Baston,MA 02HI y tom- rna-,mgor dia Wurkers' Campensafidn Inmu=ce Af &vih Builders/ContractmcslEIectrfc►m„slPhrmbers ApT ican#Infarmatfuu Pleas e•Print f�e 'b1 I`tTee3usmess,'1�rg ��1/�SS GLit7 T ems+ Address Mono 33 Are3*au an employer?Checkthe appropriate bac ' Tnpeof project(rrquired): L❑ I am a employer with 4 I am a general coairsctor and I 6- ❑New mast m,-tian employees(fall andlor•par�thne * 'have hired the sub con ttaFs 2. I am a sole a# Grp Pr listed onthe attached sheet. 7. ❑R-madeltng P�� � - Tlxese smb-cou(fract ears hav sfip and have no�mpl�ees $.-❑Demo]itiort w foE!L7P in employees and hate wom ere o -;nb �Wit`- c insuraIItr 9. ❑1301dtmg addition Lldo WPd ms comp_uecaf =0 omP. 1Q❑Eleddcal orad&tsom reed] $.❑ We area corporation and its 3_❑ I am a homeowner doing all wards officers Have•exarc-ssed thek 1LEI Flumbingrepaiss ar additions. myseL _ right of exemption per M(M ry insuranc�e��i a I52,§1{4�andwe have no Roofrepaiis employees_Wo�emtus' 13_❑other cqp.inmrxnce required_) IA-.yapp fstcheckssboxrlmat aim fllontthesecdoub9awshuvdn4tbeirno&enr 'cmmp-3fieaPencyiraon2gob #Sa�eoGraersvrh0 snb�t r�ri_s�da[�inn tHa_y azedaing s1F•vc[�c gad ifimhiie outsiderratmttors�st sn7tnvt anews�daeit mtil3cv�ns rnrFi ZC0ntmciu6tfistrhecYtW b=muststtachedau.addi[i-sl beg showing thanvmeofthesub-coutsc_6o-a•audststewhelhecor not thnse=dtks;lia%,P- e np7ayee5.7fthemff-cantactmsbaseemPiofers,Ehe}'mn4tlnuvide t.dr vrarke&•ramp.po aumiser ' I urt[ar[eutpl�r Eliot;isprgt-zriirtg i[�orkers'camr�er[sr�iar[i[msriragcs�vr�}*empluj�ees $elary is f�'��patic}�rurrl jabs�it�r irm�armrrtEon �1 p r� ' Insurance Company INamm: Pflri�y »r tic_ r= ; aDate: Job Site Address: 1 XLQ S l CitplState��sg: �1 �. W14 vZ 6 d Attach a,copy of the ra orl-ene comrpe=:Ltioapolicg-dQclaration page(Showing the policy mwker and expiration.date). FaRme to secpre coverage as regaireduuder Section.25A of MGL a 157-can lewd to the imipositioa of crimiml pema% s of a ,ire up to$U.M.00 and'or one yearimgrisonmeiff,as well as civil.peualties in the form of a STOP WORK 01ZDERAnd a Rme of up to$250-00 a day against dm violator_ Be advised that a copy of this statement maybe fog uded to the Office of Imves6gaticns ofthe DIA for insurance coverage-verification Trta�[ereixy c tdar tk9 paa[s m[dpmaR&s a,fgM�u-x?'fhatfi[a inforvurfFinaptwir dabor9 i5 fr[rs grit correct $mtmafuxre- � ' I at t�2 2 o Phone j 4( tlzlad am anfy. Da[tat writs in this=a,to be crrrupfeted by r-4 ar M11 t[,;�jiciaL City or Town: PermitlUcease g Issuing mfharitg(carte one): L Board of Ilealth Ruilffing Department 3.MyNown.Clerk 4 Dectrical Inspector 5.Plu nibmg lwpectas 6.Other contact Person: Ph0ne 9: 6 Information and Iasi c OUS mk& a; offs Ge7ieaalLaws chapter 152 regoires aII e�Ioyers in provide workras'c�PeIIsaiionforibeir nyees: Purs�a*+tto this staff,an�Ioyee is defined as-`°_. rypersonmfhe service of anofherunder any cDntraiit ofbae, .express or�7aSed,oral or wH1=." An v p&yer is defined as"anindividnA paltaersl3 ip,association.,corporation or other:Iegal entity,or my two or mole of the forego engaged in aJoint ,andincIndmgthe legal reP="t &os of a deceased employer,or the receiYra or tastee of an individual,pa taMShip,associafi=or other IegA entity,employing eu loyees. However the owner'of a dwr.Ujcgh we,hagngnofmor fhant1ree apartments and who rosidesthe=iE,or the occ¢nt ofthe- awt ing house of anther who a ¢ploys persons to do mainten ce,rnnsftuc F cat or repa:ir work on such dweIImg house or on the grotmds or budding appmfena�tierefo shalln.citbecanse ofmch employmeatbe deemedto be an employes_ MM.chapter 152,§25C(6)also sfafes that¢everysfafa or local licensing agency shall withhold tie issuance or renewal of a licrose or permit to operate a budness orb contract buUMEL s k the coEumornwealth for airy applicantwho has notproff-a=d aceeptzble eyjffmce of e6mp'HanmT6tz the HGurance ebvexager-egoired." Additionally,M(ff,chaptEr.152,§25dM sf �Teilherthe canonanvrealtinor aafy ofifspoliticalsubdivishuns shall enter rote any cont ad for theperfomlauce ofpublicwmkuaff acceptable evidence of mmpli4ar-ovitb rDT,iem=fs of-(his chapter have betaP= ztedtotheMhfl mg M3ffaGrity:' Applies - � , Please fill obit the wodo✓rs'compeusai2on affidavit couple Iy,by choc1d c h boxes that apply to your situation arid,if necessary,supply sub-conixacbor(s)n=e(s),address(es)andphoneunmber(s).along vrth.their ce iffcate(s) of nuance. Limited Liability Companies(LLC)or Limited Liabl7ity Paztneships(I I P)withno employees other than file members orpartnm-s�are not rin dto Mayworkess'compensaiioninsursnce- If anLLC orLLP dDeshave �pToyees,a p olicy is rimed- D o advised that ties afdayk may bm mbmYt� td a tie D epariment Of Industrial Accidents for cbnf=ation of iusruance czverage_ Also be sure to sign and date the a�tSd3yit The¢$davit should be-retnmed to the city or townthat the appHcafon for the permit or license is being requested,not the Deparbneaf of L 1 AccidM:L- n6uldyou have any questions rag iTm-g the lacy or¢you are reqQiCDd tO obta a workers' comp ensafion poHcy,please call the Department at the number listed belovr. pelf-ius�red or�anies should enter their self-in�'�ce Iice�se umber an the�propria�IiII.e. City or Town OMdaIs Please be sure fiat the affidavit is complete and pried legiibb, The Departmenthas provided a space at the botf= ofti�e affidayitfor yoIIin outinthe eyeutthe Office of -avesdgaflons has to con actyoaregacdingtTae appfic;sn- p leas e b e srre in fiJ1 in the pe�itlHcense mr�uber which WfiI be use$as a refrnce nnmbrs In addition,au.applicant that mast submit multiplepermitllicmse applications is any givmyca,need only submit one affidavit indicating current policy nRmatiom Cif necessuy)and under"lob�e A d&ese the applies rho 1d "•II Z6 ns m ( Y or town)_'A copy of the-affidavit that has been officially stamped or madc,-A try the city or town.may be provided to tie appEcant as proofthat a valid a$d-&is on file for fut u 'permits or licenses A new a$davitmust be filled out,hash year.Where ahomeowner or Citizen is obtaining alice:Dse or p=itnotrelatedto anybusmcm or commercial v��(ie_a dog license orp�it in bum leaves eft.)saidperson is NOTreq>�d to complete this affidavit The OfficeofIn�g___os-WDUIdaffto.tl�aakyoumadvanceforyourcooperaEion�dshDuldyoahaveanygII � please do not hesitate to givr-us a c:aM The Departmmes address,telephone and fax number. COMMMWeZj*of Massach - ' - . I�egarfmont r�f�ud�IrialAccid�n� Wa&bb&tCM Facet a?727 7M xevised4--2407 -mg� Hlr'V17llM %oc i 1 irmoA 1 C Vr 11-IA61L1 1 T IIVQUr1A1VtrC 02/1W020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: The Hilb Group of N.E.dba PHONN Ext:508 775-1620 Fax Dowling&O'Neil Insurance Agy E-MAIL A/c No: 5087781218 ADDRESS: P.O. Box 1990 INSURER(S)AFFORDING COVERAGE NAIC# Hyannis, MA 02601 INSURER A:NGM Insurance Company 14788 INSURED Alessandro Lopes INSURERB - 9 Timber Way INSURER Sandwich, MA 02563 INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL UBR POLICY EFF POLICY EXP LIMBS LTR INSR O POLICY NUMBER MM/DD/YYYY MM/DD A X COMMERCIAL GENERAL LIABILITY MPT0605H 1/28/2020 0128/2021 EACH OCCURRENCE __ $1_00U 000 CLAIMS-MADE a OCCUR PREM OCCURRENCE_ Ea ocTcuEmence s500,000 MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY�JECT a LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY P �OPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY (per P $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH AND EMPLOYERS'LIABILITY LITE _._B ANY PROPRIETOR/PARTNER/EXECUTIVE -- E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? ❑ N/A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 1(11,Additional Remarks Schedule,may be attached if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. r CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601, AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. 0 Ha_v�r�• vL.1% a IN 1vr1% I ` v1 116-111r%u111116-111 I 02118/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER 10083-002 NAME: 10083 10083/2 Dowling and O Neil Ins Agcy ( c°Nro.Et): (508)775-1620 FA/Aa No.: 9731yannough Road EMAIL clmail@doins.com Hyannis,MA 02601 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: Associated Employers Insurance Company 11104 INSURED INSURER B Alessandro Lopes INSURER C: 9 Timber Way INSURERD: Sandwich, MA 02563 INSURER E: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MNWDD MWDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES Ea occurrence CLAIMS-MADE ❑OCCUR MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ OLICY ECOT OC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS ILIA B CLAIMS MADE AGGREGATE $ DED RETpENN�TIIONN $ $ �'rPd 9A5tO9 VV11BILITY X TORY LIM TS OER A P P ECUTIVE Y/N E.L.EACH ACCIDENT $ 600 000.00 A o� Icy M nB� I�� NIA WCC-500-6021147-2019A 10/23/2019 10/23/2020 (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 500-000.00 Ify es describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500 000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Alessandro Lopes is covered by the workers compensation policy. CERTIFICATE HOLDER CANCELLATION Town of Barnstable 200 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Barnstable,MA 02601 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ^� I.CK 1 Ih1l.A I C Ut LIAtSILI I Y INJUKANI.t 02/18/2020 THIS ,CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER NAMECT Gabrielle Rodrigues BRZ Insurance PHONE Et). (508)603-6777 (FAX AIIC No): (508)603-6776 107 Concord St E-MA ADDRESS'IL grodhgues@brzinsurance.com brzinsurance.com g INSURERS AFFORDING COVERAGE NAIC# Framingham MA 01702 INSURER A: EVANSTON INSURANCE COMPANY INSURED INSURER B: AIM MUTUAL INS CO J AND V CONSTRUCTION CORP INSURER C: 869 PARK ST INSURER D: INSURER E: STOUGHTON MA 02072 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM LICY EFF POLICY EXP LTR /DDfYYYY MMlDDIYYYY LIMITS LT X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE To CLAIMS-MADE F OCCUR PREMISES EaEoccuFe rice $ 50,000 MED EXP(Any one person) $ 1,000 A Y 3EV8050' 07/16/2019 07/16/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY❑PRO LOC JECT PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COEaMBIN..denED SINGLE LIMIT $ a ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED - PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY X STATl1TE ERH YIN ANY PROPRIETOR/PARTNER/EXECUTIVE EL.EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? N/A VWC10060242152019A 07/15/2019 07/15/2020 (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The certificate holder is listed as Additional Insured's under the General Liability coverage as required. R CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Alessandro H Lopes ACCORDANCE WITH THE POLICY PROVISIONS. 9 Timber Way AUTHORIZED REPRESENTATIVE Sandwich MA 02563 01988-2015 ACORD CORPORATION. All rights reserved. i g3/003 �0 bCG `'z K(m C plA 'N 19-U_& t t vc�j& Q \.kA40:rLc-j05 1 PS PA i MAPS 10/14/2004 t 0 Assessor's map and lot number ....... .! .7..:........`�,�a.�... Ce _ �0*THE rot f Q Sewage Permit number ....................................� .... Z BABBSTABLE, i House number �� s NAM .. .................................................................... �O .. ,o� �6 'F0 MAY A" - :_ TOWN OF BARNSTABLE BUILDING INSPECTOR Vic'eC /-�< �� APPLICATION FOR PERMIT TO .................... f �. ��.1............. TYPE OF CONSTRUCTION ........ .d. ... 1 .................................................................... ................................................19.f...! 5 TO THE INSPECTOR OF BUILDINGS: ` The undersigned hereby applies for a permit_according to the following information: Location .j. .. /.. .. C, . ✓ I T:)�� . . . .fi.tt�=......................................... ProposedUse ....yL.��,/./"�-I{' U(�...� ................................................................ ...................................................... Zoning District ..........:(..`:a...................................................Fire District ....................y �/�V: .. .................................... Name of Owner r....... .� �Lt....ul.................Address�0 Z CJf'�� /Y714 �c� z .... . ...................................... .................. .......I..... �'+�-yam, � C . Name of Builders /,;�. �J:..�'1 !� ....!?................Address ........................:!�12 .Name of Architect ..................................................................Address .................................................................................... Number of Rooms Foundation /o 0 CJ�F'� ee)� C.. ... .Y.............................. ... ....................... �--- Exierior .G l.. '.—...>_ N./�U�...:.......................................Roofing ...... .Sv9.: ,7AG:.. -............................................... Interior ..,... C�. �ScJ Floors ............................................. •........................................................ Heating ?.��.C....../ '/ ................................................Plumbing ....r ........<..... 's........................................ Fireplace .......................................................Approximate Cost ..G� L Definitive Plan Approved by Planning Board _________________________ - ------19--------. Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 7 I hereby agree to conform. to all the Rules and Regulations of the Town of Barnstable regarding.the above construction. ! k ! Name .............. . .............................��._�,. .............. Construction Supervisor's License ..i................................ STANLEY, JOI�i?_ A=289-93 �J 2 t t No 27597.... Permit for ....One ........... Single Family Dwelling %�� rider Location .... ....... ..................................... �IYi ?s.......................................... Owner ....JQ1.7D..5.=1QY.................................... Type of Construction ....FXaM.......................... Plot ............................ Lot ................................ Permit Granted ......Maz.ch..12!...............19 85 Date of Inspection ....................................19 Date Completed ......................................19 ' J 4... ::� , "� °► r_ TOWN OF BARNSTABLE Permit No. _2 _5g ------- { »n.n ' Building Inspector Cash .� o '" OCCUPANCY PERMIT Bond -_-__-�'-- f Issued to ohn, ' S Y ley Address Let 1, 11�cGGreenwood Avenue, Hyannis Wiring Inspector � �f r .� ��� Inspection date Plumbing Inspector` ;i� �r Inspection date Gas Inspector v Inspection date Engineering Department` Inspection date tl,�q Board of Health n , X�y , Inspection date THIS PERMIT WILL/NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ............. : ........ ` 19.. �J'r ............_....... C..... r....... . ... ! ...... Building Inspector .. • . t Y.V. i r � 4 �.. f TOWN OF BARNSTABLE BUILDING DEPARTMENT ssaa$r = TOWN OFFICE BUILDING rua \ erg' i6J9' �� HYANNIS, MASS. 02601 t MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by . Building Permit #... » ..» .., ,» . ».»»... � ................................................... .....................»......... issued to ......... ..... � !r. ZZ ,�C1 G/jT /.'d'" :...... ».... ».....» Please release the performance bond. Assessor's map and lot number ........�. : . � S ® A CSYSTEM MUST T 11 THE 1 MP Sewage Permit number .............. .r.�....f ....�\ AS�'e�LWITH r �EL� ENVIRONMENTAL COD i BaEb9TanLE, � . �~ �. � House number .. ...//....................................................: `sa b9. a 0a T("" ¢L�aT�v'yl ➢ o,�pYFYtr�9 L TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR-PERMIT TO ... L� ^........ .l,l ........................................ 'TYPE OF CONSTRUCTION ........... .�.�.�...!` .................................................................... ................ �m1�.................19. � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to' the following information: Location ./��. /..� C...../.... /.. .L..`� L�, ..., .r+........................................... Proposed Use .Ze5 /; . ;..................................................................................................I......................... I/ Zoning District ........... � Fire District v . .................Address..................................... • ... / Name of Owner ...... . � /..,.u.�.....................��� Name of Builder ' ./�'.`. v .... .. .. ................Address ........................✓.. Nameof Architect ....................................................... .........Address .................................................................................... ti Q U/2 ,0 C l-� Number of Rooms .......................4 ......................................Foundation `:./0...... � .......................................................... Exterior �.. ....� .j .........................................Roofing .....a L rr Floors ,� Interior A.........�j. l ......J.rn........J.....�.../3.. Heating ._...........................................Plumbing .... Fireplace .... .. ..<...... ...............................................Approximate Cost ......" J �............................ Definitive Plan Approved by Planning Board -----------_-------------------19________. Area .......... /P............. h q• r Diagram of Lot and Building with Dimensions Fee . � SUBJECT TO APPROVAL OF BOARD OF HEALTH �S OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 4 I hereby agree to conform to all the Rules and Regulations of the Town of arnstable regardin ,the ob ve construction. Name ..... ........1 ...... ................. !.. V :2 .ate Construction Supervisor's License �......................... -STANiEY, ,JOHN No .2.7,597. -.. Permit for .:..One..Story................... ........... Single Dwelling . ............ ....... Location L6t...1..I, ....... .... .. -------------- .... Hvamiis .............................................................................. John Stanley Owner ........ ............... ................... Type of Construction Frame......................................... .................................................................... ........... Plot ...................... Lot................................. Permitf-Granted .....March 12. ..............19 85 ........................ .. I--- . 1� 7 Date of Inspection.... 9 ..........1 Date''Completed ..... ....... ..........1-9 Aln #S(, 4/0 /Yoiwl _r...__ sNELt7- / a, Z ShVe'7-5 v 9 �k a,3 LOT 1 _ i N _ rl77 , Zo o r".5E,evc Skpne- .—� TA�vG Q H r ' ,off ,�3 sox ,o'a•'�' Z` A0,00 i N�_ �ZcWf}-T7v,v s Qsrs� oti L W�9T�172 T�7BLE•` 4�Z/�BL ►! =o:00 CERTI FI ED PLOT PLAN LOCATION . 11109A!.!V/s 14.ss. SCALE . .�.��" 30'.... DATE OF �,��� _ J, PLAN REFERENCE . I CERTIFY THAT TH E 491.577AA /GING/4�7.✓. . SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF WHEN CONSTRUCTED. — DATE ��$. .�a./J�,6?,5"�`�x-+••C ��� , 1/o%/A/ STA//G - Per/7-/0,k/E7- REGISTERED LAND'SURVEYOR u TOP OF FOUNDATION CONCRETE. COVER CONCRETE COVERS e e 4' CAST IRON „4 2 �mni�rn ' OR SCHEDULE 40 12"MAX. T. P.V.C. PIPE 4"SCHEDULE 40 PV.C.(ONLY) ' PITCH 1/4"PER.FT PIPE - MIN. LEACH PITCH 1/4 PER.FT. PIT PRECAST e a LEACHING INVERT INVERT n+ w� 1 PIT OR SEPTIC TANK DIST. e INVERT EL.//r�?�. • . BOX EL//.37 > EQUIV. ,a', EL./.��.�.�. . .. .. GAL. INVERT S� Ea. �- r EL//. .'� INVERT W W :i: 3/4"TO I I& EL.//o� �� WASHED n e W STONE WDIA 61A�fd o , PROR LE OF ROUND WATER TABLE EWAGEf- DISPOSA YST NO SCALE SOIL LOG WI. ESSED BY : DATE .g�Z//BL... TIME. . 39 .'4"'� • BOA OF HEALTH TEST HOLE I TEST HOLE 2 ENGINEER ELEV. . 7 rcc?. . . . ELEV. .. .. . . . . . . .77"77- lq. 7o f�_Sod 4 ESIGN DATA : tZ.S-Sv NUMBER BED OMS 3 TOTAL ESTI TED FLOW . . . a . GALLONS/DAY BOTTOM LEAC G AREA SO.FT. /PI TIC P.D, 40„ SIDE LEACHING REA . . .�'`7��, . . . SO*FT./ PITIJT�Z,7C,RD E2, d,o0 GARBAGE DISPOS . Nv. . . .(50% AREA\INCREASE) TOTAL LEACHING EA .z-3✓` •.G . SQ.FT PERCOLATION RATE S .?f//-h✓.T11/q MIN/INCH ii LEACHING AREA PER ERCOLATION RATE "171. . SQ.FT/L!tDp .9e. .WATER ENCOUNTER NUMBER OF LEACHI PITS AFT. Wi771 APPROVED . . . . . . BOARD OF HEALTH 770va •fir S'rzani o'v •�?'�' S/DES DATE . . . . . . . . AGENT OR INSPECTOR OF N �/ u ifELLEY W R' j ri+ . . . . . . . . . No.26100 Z, /STEP oe S EAR / S U R V Ey �t� srNRaR\P� PETITIONER : � f/-/T/ S� �F y r, f t NN t � i ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 603 ,/lap Parcel _ABLE Permit# Health Division � Date Issued Conservation Division S �Zl - GQyt -- 1112 MAY 2 j PM T 21 Application Fee Tax Collector (? ( �C--AILPermit Fee �Q 1 Treasurer 'k I —Q k ivlsloN SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE VM TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULATION1 Project Street Address Village 40 ,_5 ✓f'1 A Owner I'Vl i r o ( �o h�„Sn,� Address I 1 C re-e/-i ncc4 Telephone 5-0A 97'7 Permit Request n6Am�N nn $ ifce,4 b-.f Ia Ff Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation i;t50 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 11 2 S Historic House: ❑Yes CJo On Old King's Highway: ❑Yes /6"No Basement Type: /Full O Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing 3 new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil /Electric ❑Other Central Air: ❑Yes )dNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes Crlo Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# ;Current Use Proposed Use BUILDER INFORMATION Name g o1� �a .1 soe� Telephone Number �P ��� I✓��� Address I I �r a_,; t,rCrt J 1y e_ License# 81 Q An rh. 0'�"ELI Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO _ Re'56ur5,e SIGNATURE DATE ___, -4/dQ FOR OFFICIAL USE ONLY r Y PERMIT NO. DATE ISSUED t - At _ s MAP/PARCEL NO. ADDRESS - VILLAGE OWNER i, DATE OF INSPECTION: FOUNDATION " t' FRAME T INSULATION r I FIREPLACE ' ELECTRICAL: ROUGH FINAL - ' PLUMBING: ROUGH FINAL R GAS: ROUGH FINAL - FINAL BUILDING , = ► i_ DATE CLOSED OUT ASSOCIATION PLAN•NO: s` — f V °EIKE l Town of Barnstable Regulatory Services " BARNSrABLE' " Thomas F.Geiler,Director — ije i6;9• �0 , tpp�(A Building Division Tom Perry,Building,Commissioner 200 Main Street; Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. .Date 1 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: .DeGk Estimated Cost o Address of Work: of Av.Q Owner's Name: Date of Application: 00- I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑B ilding not owner-occupied,�26 ' wner 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 . Date Owner's Name Q:forms:homeaffidav _ The Commonwealth of Massachusetts Department of Industrial Accidents office ofinsestioations 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: M i CXl AQ l (Qo cn S cY� location• I aS Se-0 J d p✓' 44je. --- ci A i phone# I am a homeowner performing all work myself. ❑ I am a sole go etor and have no one workin m* an ca achy ❑ I am an employer providing workers' compensation for my employees working on this job. X. eomnanv name ...: : .........'........ ;:::: >:: ;..:::'<::...... phone#:. c�ty :....::,..,......... ' .::;:.. uli .dl .. / ❑ 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: companv name :'. :::.......:.. 21itf'CSS 'ass > n. 'i2'>issi '` ?s5 ! < ?>ii' i2 >as' <>s2as %a<iiiii ? sia >%? 5i> 2ias!!5! [! ssi %? i>f '? .............. .........................::..... nko ............................................... X. ....:::....::::.:.................:..:::::...:::.;::::::.....:..........:;...:......... ....:........:..:...........:......:..........:....::.........:....... ...... ...................... . .......... ;c as n XX adtfress ....::::::.:::::.;: :;:!::: f:<j: v:ii:::::::::Ji:}::i:':::iii:!�i:::::::{:::::::::::%:i::::::::i:::vi?i::i::::::is::::i::i:!:::::i::::::::i':::i:�;::'i::�i::i::::?:::isi::::::::::i:::::::i:::�:::i:i:: :'::::'�::'::::':::' :iii!�::�'::::'::::::::::::i::::::i:::'::i::i::::j:i::::::i::i::::i::i::':i::::i::::?i:::::::i:::::?i::i}}::i:i:L::jLn:::i:: .h.ii.,:..:iiiiii:v:S:ii'..i?iii:i::<4i:::•Y:•iiii::vi:::.;':::.. :::...:..:v..ii:<•'':':'.:: is".::.::::Y?..'..:•: . Cl. v...::•::.::::::::.:::::::. ue. ...: Failure to secure coverage as required ender Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to s1,5o0.0o and/or one years'imprisonment as well as civil penalties in the form of a SWOP 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 Office of Investigations of the DIA for coverage verincation I do hereby certify under a pains and nalties of perjury that the information provided above is true and correct "Signature " Date ai-oa-- Print name i 'CAA 0- Q ob t n's a n Phone# .,ao F` -77 f'W-7 official use only do not write in this area to be completed by city or town official city or town: permit/license# ::0H:ea1thDepartmentt ilding Departmen c—mg Board . ❑checkif immediate response is required ctmen's Office contact person: phone#; er Unised 9195 PJA) 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,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 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' 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 ilie 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 pi number which will be used as a reference number. The affidavits may be returned to the Department b mail or FAX unless other arrangements have been made. eP Y . - 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 Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 i VO � 9 V' l V ffe sur 2 4-r'e 01 f- aid a by e�S,N RZ. !.lL �3 k Lo T 411 . �•?. `\ a PrZ-pos« q Y) cp ol/' ' ds t�t,E Ii,l. � ro10 . Ze.i �• L,� .. �t.• 1 �sE,evE SS O r i H r ` 'Disc. ,0 ,�/ !o•. 10, 3 sox loia 1 A0,00 3 i NnT�''= �Z�'YR•nU.v 3 QA�� d.v W,17-&72 7z}84,4 9/Z��BL ' - CERTI FI ED PLOT PLAN LOCATION . 11Vg,,v!11s / 4 ss SCALE DATE PLAN REFERENCE J sti6ww o.v , I CERTIFY THAT THE 70 SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF ��?l /,S?�1�L • .•. . . . .WHEN CONSTRUCTED. DATE r� .�8/�8,7�`22��L�-•+►� � Re-rl T/v Al e7P_ REGISTERED LAND SURVE R Town of Barnstable OF 1HE Tp� " Regulatory Services V,P O anttivsTns[E Thomas F.Geiler,Director 9� MASS. Building Division '°rBn ,t a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 5--cad _0a 1 JOBLOCATION: 1 .7 �ct+d��r Rye Nt .a.iln'S }'Yldr na6a 1 number �� street village "HOMEOWNER": MiJ )Ae.I Qob%nwn 50R--7 _7977 name home phone# work phone# CURRENT MAILING ADDRESS: r¢_p-!� we>e 4.,C,nn1-) i? ,4 0"n 1 ity/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 su ervisor. 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 inspe ti procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger.will be required to comply with the State Building.Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt �oFt rati Town of Barnstable *Permit# Is- yP �� Expires 6 months from issue date BABNSTABLE, : Regulatory Services Fee 00 v ,6 9. �0� Thomas F.Geiler,Director �AtED 1 A°'`p Building Division Peter F.DiMatteo, Building Commissioner XP ESS 200 Main Street, Hyannis,MA 02601 PERMIT Office: 508-862-4038 - JAN 2 2002 Fax: 508-790-6230 0 N EXPRESS PERMIT APPLICATION - RESIDENTIAL ONL F B'�R�STgg Not Valid without Red X-Press Imprint Av� L� / L qap/parcel Number ?roperty Address 2—Residential // Cy �`� �� Value of Work VS GO.�a )wner's Name&Address /�//G AL( / L-C ac I g ,ontractor's Name 17e Telephone Number Od S 3 6 7 lome Improvement Contractor License#(if applicable) :onstruction Supervisor's License#(if applicable) -lWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor eE]-I am the Homeowner ❑ I have Worker's Compensation Insurance ssurance Company Name Jorkman's Comp.Policy# ermit Request(check box) Z"Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. gnature Forms:e trg Tisw 1901 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1 FL., 367. Main Street, Hyannis, MA 02601 (Town Hall) DATE: �� I �� Fill in please: ` APPLICANT'S YOUR NAME/S: V66.1'NALDU lV Uj'N D r G BUSINESS - YOUR HOME ADDRESS: SxEn--Al Wool-) t� L C> � TELEPHONE # Home Telephone Number NAME'OF CORPORATION. NAME.OF NEW.BUSINESS Ekfe A/ ::: 4Z&ZF C TYPE OF:BUSINESS ' INA5 IS THIS A HOME OCCUPATION? YES NOS ADDRESS OF BUSINESS Ltlat�i /U/ MAP/PARCEL NUMBER �j3(A..ssessing) 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 s Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses.required to legally operate your busines J. n t 's town. 1. BUILDING COMMISSIONER'S OFFICE. ( - This individual has been informed of any permit requirements that pertain to this type of business. r Authorized Signature** 1 COMMENTS: v 2. BOARD OF HEALTH This individual has been 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: ,k