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HomeMy WebLinkAbout0086 HAMDEN CIRCLE g� -��,�e� C� ��� 4 M 4 e! -------------- 44V I'D o kVr 1 J!;ItF+ _t "- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 9� Parcel 1 -7 T�' � Q1i( €1 , �.,w Application 4(:�&/Lb(�7�9 Health Division Date Issued 14 !UL 24 rP" ; , Conservation Division - Application Fee Planning'Dept: Permit Fee Date Definitive Plan Approved by Planning BoaDIVISI N'l Historic OKH Preservation/ Hyannis F, Project Street Address` b4Aw VZ#U Cites Village `(1 A Iiii 15 Owner i-•AUmic CoqbLVerv-- Address) ? t4Ato '� 0&3 �r✓� Telephone J 0� `�'�'1 Permit Request r®l�, O a-M O + R 9 PA 1 A_- u 1 5 E_ Wi N Douis . ROOF Square feet: 1 st floor: existing� proposed 2nd floor: existing proposed _Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 00(0 Construction Type Lot Size ACAES Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family. Two Family ❑ Multi-Family (# units) Age of Existing Structure 3(6 Y Historic House: ❑Yes VNo On Old King's Highway: ❑Yes Vlo Basement Type: Tull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) F°r— Basement Unfinished Area (sq.ft) scQ # - 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 Count Heat Type and Fuel: )(Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes Vo Fireplaces: Existing New Existing wood/coal stove: ❑,Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:Wfxisting ❑ 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address t a.a Pc&j& s�r License # CS d 07 ON L3 'Y1- w�•J�, Da1 3 .Home Improvement Contractor# t a,9 a 44 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE tR> `:r UJ 7 DATE FOR OFFICIAL USE ONLY APPLICATION# E DATE ISSUED MAP/PARCEL NO.- ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: FOUNDATION s - t , FRAME FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL f :GAS;-, ROUGH-j=,r FINAL 'FI'NAL RUILDING? " DATE CLOSED OUT. 1 _ ASSOCIATION PLAN.NO. IF' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lealbly Name(Business/Organization/Individual): Whalen Restoration Services Address: 22 American Way City/State/Zip: South Dennis, MA 02660 Phone#: 508 760 1911 Are you an employer?Check the appropriate bog: Type of project(required): 1.F] I am a employer with 25 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers'comp.insurance comp. insurance.+ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work off .❑ officers have exercised their 11Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. %Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have . employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Ace American Insurance Company Policy#or Self-ins.Lic.#: 6S62UB5B894542 Expiration Date: 4/1/15 Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day,against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and enalties o(Xedury that the information provided above is true and correct Si nature: � �� �"-� � Date 7 a't Phone#• S-1?Q- `7 ke,b L�9 ' 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 Electrical Inspector 5.Plumbing Inspector 6.Other r, Contact Person: Phone M ,14 Attention Building Dept. Attention Sally, Please add these documents to the building permit application for 86 Hamden Circle. Thank you CD Q C D C-3 s" Pagel �.. CERTIFICATE OF LIABILITY INSURANCE DATE 7191DDIYYYYI T IIPICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTI FICATE HOLDER. THIS C.ERTIRCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS�CtRTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE E .AND THE CL'qME12&7,.HQL DER. MPORTANT:If the certificate holler Is an ADDITIONAL INSURED,the policy(fes)must be endorsed. If SUBROGATION IS WAIVED,subject to the arms and.conditions of the policy,certain policies may require and endorsement.A statement on this certificate does not confer rights to the ettlficate holder In lieu of such endorsements. PRODUCER CONTACT NAME: HUB INTERNATIONAL NEW EN PHONE FAX 265 ORLEANS RD (AAC,No,Ext): (A/C,No):. "AIL NORTHCHATHAM,MA 02650 ADDRESS: 77GKF INSURERS)AFFORDING;COVERAGE NAIC P INSURED INSURER A. ACE AMMUCAN INSURANCE COMPANY WHALEN RESTORATION SERVICES,INC. INSURER B.- INSURER C: 22 AMERICAN WAY INSURER D: INSURER E: SOUTH DENNIS,MA M-66D INSURER Fe COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: "m IsTaTrwimpy MAT INC OLICESOF INSURANCE LISTED BELOWH THE INSURED NAMIEDAROVS FORTHE POLICY PERIOD INDICATED.NOrAWHSTANDING ANY REQURIEJENT;TERM OR CONDITION OF ANY CONIRACT OR 07HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INBURANCE AFFORDED BY TM POLICIES DESCRIBED HEREIN 6 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LVAUG SHOWN AMYHAVE BEEN REDUCEDBY PAD C.LAIMS- INSR ADD 6UB POLICY EFF DATE POLICY EKP DATE - lTR TYPE OF INSURANCE L R POLICYNUYBFIR (IngDdYYYYI (MNDD%'4IV" LIARS GENERAL UAMUTY ZACH OCCURRENCE $ rGEN'L MMERCIAL GENERAL LIABILITY i AMAGE TO RENTE $ CLAMS MADE a OCCUR. REMISES(Ea occur ty. ED EXP(Any one Plu—a ) S C$ ERSONAL d ADV plJUFEY $ C_ GREGATE LIMIT APPLIES PERT ENERAL AGGREGATE $ ;M=UCYED PROJECT Q LOC RODUCTS-COMP/OpAGG $ AUTOMOBILE UABILRY COMBINED SINGLE $ fa ANY AUTO LIMR(EaeccideM) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) ; HIRED AUTOS BODILY INJURY' $ NON-OWNEDAUTOS (Per accident) PROPERTY DAMAGE (Per accident) UMBRELLA,LIAB` HCLAFAS-MAD OCCUR EACHOCCURRENCE $ EXCESS LIARE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ T KERS COMPENSATION AND WC STATUTORY OTHER LOYER'S LIABILITY . YM UM8894iQ-14 04l01/201'4. 04/01/2015 LIMITS ANYPAOPERITUWPARTNERIEXECUTIYE N/A - - E.L EACH ACCIDENT S 1.000000 OFFICERIMEMBER EXCLUDED?. (MardMoryhNN) E:L.DISEASE-EA EMPLOYEE$ 1,000,000 If yes,desedbe abler - - DESCMPTION'OFOPERATIONSbabw E.L.DISEASE-POLICY LIMIT $ 1,000.000 OESCRPTTON OF OPERATnONS/LOCAIIONS/VEHICLES/RESTR t=ONWSPECIAL ITEMS nu REPLACE$ANY PRIQR crnti- GATE ISSUBD TO THE CI3R71RICATENOLM A}fECIWG WORKERS COMP COVERAGE PRW=:86 HAMMIN CRCLH,HYANNIS.MA OMOI CERTIFICATE HOLDER CANCELLATION - LAURIE CROCKER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED lib HAIdIEN CIRCLE BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL U DEW D' IN ACCORDANCE WITH THE POLICY PRO AUTHORIZED REPRESENTATIVE HYANNIS,MA 0.2601 ACORD 25(2010/O5) The ACORD name and logo are registered minks at AICORD 1088-MID ACOR O COR r O is reserved. n/le�rfN/4/NfFNRIGfI�//fj. Y`��„ff uHlls Massxhuseft:- '�a ellt Of P b#c$atC� ttes 8oarcl pt,Bu M ul�rtions,are# ce of Consomer Affairs&Business alafioa , E iMPROVEMt.NT CMMCTOR Co ` .. 7pe• rationf7} r Prorate Corpora6o, Whalen Restoration Services Inc: iZl,POl s WiUam Whalen 22_American way South Dennis.MA 02660 "-""�pf - s... � ' >,IIA 1�Xpigdjon Undersecretary Convnissioner 0$MQf2014 Unrestncted $tub puny use which License.ar registrationwalyd foruilividal use only a before the e:piratiari date. Irfoufiili'return to: kiiih8p 3S�tQ tic (9911a� )of Office of Consumer Affairsand Business Regulation �� 10 Park Plaza-Surte 5170 Boston,MA 0"2116 , iailime to po" a cumt athtbn of the Musetts _ State$uildirg Code is cause t,., mmim Lion io Of"'I iifse(se. y Not valid without signature For 0Ps U=Uinf infM"M ionVWt W".Mass Gov/DPS. Y 00 Restoration Services Inc. Fire, Smoke, Soot,Water Damage&Mold Remediation Services Cleaning - Deodorization - Reconstruction Specializing in Fire Restoration -All Work Guaranteed Access, Authorization and Direct Payment Request Form I (we) authorize WHALEN RESTORATION SERVICES to perform work as per estimate at property located at 86 Hamden Circle, Hyannis, MA 02601 to repair damage caused by fire on 3/18/14 As owner(s) of this property, I (we) understand that I (we) must authorize this work. I (we) hereby authorize WHALEN RESTORATION SERVICES to perform this work and accept responsibility for payment upon completion. (we) authorize and direct my Insurance Company Narragansett Bay., Claim # OIMA10260108 Policy No. 10260108 , to make payments directly to WHALEN RESTORATION SERVICES, Insurance Claim Specialists, for doing this work and to that extent I (we) assign the benefits applicable to this loss to WHALEN RESTORATION SERVICES. I (we) acknowledge receipt: f_a copy hereof: � OWNER DAT D SIGNED _ "V OWNER WHALEN RESTORATION REP. SIGNED 22 American Way, South Dennis,MA 02660 Phone: (508) 760-1911 Fax: (508)760-9995 - 1-800-244-2598 -E-Mail:restore@whalenrestorations.com Web Page:http://www.whalenrestorations.com OFFICE COPY=WHITE CUSTOMER COPY=YELLOW .AVys96 • pit. t f� ' W iAl 11 'e 'I�..�TTT dd11 r e• 3 M Ilk E Town of Barnstable 0p 1HE T Regulatory Services Thomas-F. Geiler, Director - * BARNSTABLE MASS.. $ : Building Division. ''rFo r�r►+° Thomas Perry, CBO, Buldin Commissioner g 200 Main Street H a y nni s MA 02601 www.town.barnsta ble.ma;us Office: 508-862=4038 Fax: 5 8- .0 790 6230 EXIT ORDER DATE: :LOCATION: UNDER THE PROVIS-IONS OF 780 CMR, THE STATE BUILD G CODE, SECTION 3400.5."1, YOU ARE HEREBY ORDERED TO IMMEDIATELY DISCONTINUE THE USE OF THE CELLAR/BASEMENT AREA FOR.SLEEPING PURPOSES. AL NSPE O a SIGNATURE iOF RECIPIENT O.DEM.DE SAIDA DATA: LOCALIDADE DE ACORD.Q COM 0 PROVISORIO 780:CMR, CODIGO DE CONSTRUCAO DO USAR; IMED�GRAEO 3400.5.1, VOLE ESTA ORDENADO`DE DEIXAR DE ESTADO, PA RA IMtNTE, A AREA DO'PORAOBASEMENT.PARR O.;.. PROPOSITO DE DQRM IR.: ,. 1NSPETOR LOCAL: A. r ASSINATURA DOS RECIPIENTE >' r"•''kShs a .. ,s�. ,::+�y,,•.r,ar.. ,Ylv .._:..::r. ,,:.o. yvrx..:YiS:t'c yy;;.e. y.+t F:+� 6in._ ."-. „��:.12,d,,;'p';4i?..o.J..'.;,r-,%:�•..:.-'Y4_�".i-.A i'^.?' `... '" T ,�..rir+• +`ifC'' "`' w . -tlrY •.....,.,. -'"f`�'�^.`4'w vai"+... r Town of Barnstable Op THE T • Regulatory Services Thomas F. Geiler, Director • BARNSTABLE, 9 MASS` $ Building Division i639 �0 ArFo �A Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXIT ORDER DATE: LOCATION: r�� ___�_i� rr�r' r'1 �t/C � ,a K-) n UNDER THE PROVISIONS OF 780 CMR, THE STATE BUILDING CODE, SECTION 3400.5.1, YOU ARE HEREBY ORDERED TO IMMEDIATELY DISCONTINUE THE USE OF THE CELLAR/BASEMENT AREA FOR SLEEPING PURPOSES. FOCAL NSPEC (0- SIGNATURE OF RECIPIENT ODEM DE SAIDA DATA: LOCALIDADE: DE ACORDO COM 0 PROVISORIO 780 CMR, CODIGO DE CONSTRUCAO DO ESTADO, PARAGRAFO 3400.5.1, VOCE ESTA ORDENADO DE DEIXAR DE USAR, IMEDIATAMENTE, A AREA DO PORAO/BASEMENT PARA 0 PROPOSITO DE DORMIR. INSPETOR LOCAL ASSINATURA DO RECIPIENTE 4/15/08 86 Hamden Circle 11 AM- R Giangregorio Birst Team to inspect 86 Hamden Circle on 4/15/08-Owner: Terry Holmes 508-775-1760 Reported to site with Officer Alexander., Tom McKean, Tom Perry, Charlie Lewis, Lt. Don Chase, DC Dean Melanson, Tim O'Connell. Tenant Leno Mendes refused to admit team but did allow me (With Officer Alexander) to enter the upstairs. The downstairs was locked and we were unable to access unit. Mr. Mendes will allow us to see property with FD on Thursday(4/17/08). He will call. -A 09/2008 0.9:22 5087786448 HYANNIS FIRE PAGE 0.2 I n j ❑ Delete NFIRS - 1S L� 01922_j MA� 3/2I/2005 L0'I . � A2S0298, � 0 ❑ Change Supplemental Slial6 ,.� 1 ate $latian InCidarn Number * EXppsure K2 Remarks L� 0 liAMnl';N GIRCL —ID Robert Tucker walked into lobby of station to make a complaint, a is a caretaker for a property near 86 Hamden Circle. He states the house is overcrowded with people and he has complained to the Board of Health about it. hle states sometimes there'is 20 cars in the yard and street blocking traffic. "e is concerned about public safety trucks getting around the neighborhood. I advised hirn to contact the police when this happens. is I took a ride down to the address. I found four cars located in the driveway at 86 Hamden Circle. There R were no cars located on the Public street. No hazard found. 1 cleared and returned to quarters. 1, William J. Rex, .►r ; ;}r t" e G71:;YI?OA FVO n 7/71/7/1n9Z 44YAAIA/Tc FTDF nx:OQDTMx7A/7' MFTO(Z D:=Dr)OT D4rF Y 4409 2008 09:22 5087786448 HYANNIS FIRE PAGE 01 95 High School Rd. Ext. Hyannis, MA 02801 Hyannis Fire and Phone: 508.775-1300 Fax: 5o8-778.6448 Rescue Toi �) Zo 4 ( (��.,., From: �t sf Fax: Date: 6+ q Phone: Pages: �. Re: CC: ❑ Urgent p For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle *Comments- . 8•7"Vir _'` 20320 „ '�. TOWN OF BARNSTABLE `�� •°, Permit No. --------- -------------- ----- Building Inspector $328.00 (owner) 1 31wST.m. Cash - OCCUPANCY PERMIT Bond ------_-----------__________ "No building nor structure shall be erected, and no land, building or structure shall be used for• a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Cedar Acres Realty Tr. Address Great Pond Dr.,South Yarmouth lot #77 86 Hamden Circle, Hyannis a e --t oe Wiring Inspector Inspection dateA/�,,e>,�.•r Plumbing Inspe t r I,-D �� i\ ,.r Inspection date Gas Inspector . Inspection date ✓Engineering Department f ' 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. ............ ............... 19......__ ..................................................................................................._........_._ Building Inspector gjesst7r's map and lot. number ....... .✓vw 4..... .....'�. �' � — �' ' ' -7e � n s SEPTIC SYSTEM }�^OAT, l� , ;^ SLwage.'Permit number ........._........... ... .:................ STALLFP� ilV COMPLIANCE s ' , WITH ARTICLE II STATE Qy�F`TNET�� w t TOWN OF :B TL �9-T,�A }JEE c.' ♦w 4 7 i W Z B9BB9TOBLE,� rasa t BU}ILDING-' INSPECTOR 7 �O i63q. .'0�•E tlPY a � � 4 - VID APPLICATION, FOR' PERMITS TO ............... j� .......................:. TYPE OF CONSTRUCTION .. . �,%dr ' ,1Vwve,..r—...1.� .,/» ,- tLB :.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a perm/itt according to the following information: Location ........... / ......../••:. ......... f'./... .l�f'1. 1 Y....... f't. ... Proposed Use ........... ...... .. , ...................... 11 Zoning District ...........��...4...............................................Fire District// !T.. Name of Owner..(- ��-:� f-r. .. U Address ........ Name of Builder .... !,!%tlrd�e4-- Address ...................... 1!f ....:............................... Name of Architect .......... ............................................:.....Address ............ ................................:......... Number of Rooms ............ ...... ..........................Foundation 1iv /d �.. R� l�'�,1.Roofing . ..... � J ..... Exterior ..... ..... c?tiJ�. ...... . .. ... . Floors .......... '. ..... ... . ... ...... ................................Interior ...........4� �' ...� ,A-OY...Plumbing .............. .. .. � ., ......... ................ Fireplace ................ . .... ..........................................Approximate Cost .................t�i f�.!.:.................... Definitive Plan Approved by Planning Board -- - - ------- - - 19_ ----• Area �1..�.............. Diagram of Lot and Building with Dimensions Fee �./.�................ . ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH r I-hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. N � v .4 Name_ ... .. . . . ?...... . .. . .. _ ... .<1 ���` .. f � | | ' / ! . Cedar Acres Realty Trust 203story .'^ < -- Permit ~~~ � � -~r fami d�mll��8 ' ^ " = . ' - Location —'.a� uamoeo �z _. , ~ Hyanni .-----^—.°—.—.,---- —. ' ' | Owner --..�����.�����.�Re����..z _. . . . Type of Construction ...........�����`..................... ' 41 - ' . . ^ . '--'—^--'''------'----^--''r---' . ` #77 , ^ Plot ' Lot ' - ' —�7---- --' ----------'' , ^ ' ���� l9 7@ . Permit Granted �----------'--]Q ' . . Date of Inspection ---- ....................... . ' , [ate | -_� ^ PERMIT REFUSED � . ----..---._....—..--------.. 19 . � . . . ' ^. � ^ ,—.-----._~--.--,.,,.--.----.-- ' -^ - , - . , � '.�_-.—...------...—'..--.--,—..—.--. .`..-.—.--..—.---.------.—.......— ----.—...-.'^�--.—..........,..—'�.--... . . . ---------------.. lg' ~� . -------.------...--..,—.—,.—.~.. - , . ----~------..--.------......... ` � . Assessor's map and lot number .........?.'.....t:.. .........'......l Sewage Permit number ........................... .............................. I"E.T°�� TOWN OF BARNSTABLE BARNSTABLE, i OMYae� BUILDING INSPECTOR APPLI CATION, FOR PERMIT TO .. .............................................................. TYPE OF CONSTRUCTION ..... .n � f�J, !'.. .�..f �.............. t .................................. �..� ... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby/applies for a permit according to the following information: Location ,� .!' r/ 7 f'7' � i!�? `. C/L� c'- ......!.. ......... .......................... ...............V........................................................................................... .i �.1:-� .......Proposed Use .......... r ..�...i l ....�r...�fi. .. .... ................................................................................................................ /� t Zoning District .................................................Fire District Name of Ownere.!:?.!: a. /�/ os.(r'41;7, ./Address ........ / /r?.................................. / .............. . ... ..... Name of Builder .. ... ..... ...... aka... a .f..!�L�Address ......................rr..�r.` I, '..................................... �f Nameof Architect Address............. .?................... .................................................................................... _ Number of Rooms . " ...;�. A.............................Foundation �—'f �y i / ........ ..... .................................... Exterior .....t: l...r .. f...c1.'�!'......:� ..c aiwi�.:--.Roofing ......14�r] /", �flaGD ............. ........... Y _ f Floors f'.._ —...........................�7 ....Interior ! rr-7.e.i �.�i. -'`f r......... ............................................................. Heating .....!:?:.f` ./. �'.......................................... ; r' Plumbing ................. :?. ........�. .....?:..�:.:: 1............... Fireplace ................... .........................................................—Approximate Cost .............................................. Definitive Plan Approved by Planning Board ________________________________19________. Areafl........... �Ij Diagram of Lot and Building with Dimensions Fee '' — ......... ............. ou� SUBJECT TO APPROVAL OF BOARD OF HEALTH i FI ri i I � � v I I f r r' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name r!..." �' �..- '.... Cedar Acres Realty Trust A=290-171 No ...,20320 permit for „one story single family dwelling Location .......86 Hamden Circle ......................................................... .....................Hyannis.......................................... Owner Ced..a.r..Acres. . ..Realty. ...Trust. . .......... .. .. . ...... ......... ... ...... . .. Type of Construction .......frame.................................... ............................................................................... #77 ` Plot ............................ Lot ................................ Permit Granted ........June 19 78 Date of Inspection ......... ...... .................19 Date Completed ..................... ................19 PERMIT REFUSED .................................... .................. 19 �! ............................. f y ........................ ............... ......... ..............................................i................................. Approved ................................................ 19 ............................................................................... ............................................................................... f� . c j 7 l 111 GCS SF i to N ,Fovim►.0, 3! HAw1r�E►,J Gtec�E • P� S�o���t,!Gw 1=-It3vSE �C/�T�ot..l -�y�tilt,.1 iS (&Z.JSTAZCt., �cA-55 . "_ o' Mai 22.) v���, OF I HEREBY-CERTIFY THAT THIS FOUNDATION AS LOCATED ON THE LOT AS S140Y01` -IAND IlORMAk CONFORMS TO THE TOWN OF 15AA IST keC—ar � ZONING REGULAtIONS REGARDING SETBACKS W GROSSMAN to (ROM STREET.UNES AND LOT LINES. .�� 12775 �® s q NcxzrtAAJ.ti4�'aS31w�. K.L.S. �y� SUIR4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 2—clO l Map Parcel Permit# �� 4L Health Division " C Date Issued O./�Conservation Division %a S• 0�4 /O,j Application Fee Tax Collector Treasurer INSTAUED IN COMPUANCE IIVITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address 8 (o VV1 d P U\ Village A� a n V-1 i Yl\- 0a16 01 Owner _ �I It GI VA �'��eSo. �MP5 Address a- ® f' lL' ' S. Au- ..finis Telephone 90' `l 0 L 3 a 3 11 49ermit Request v j�a� ! bu`1 K KOA cA I��' q_cq Q c( dt A h S-Q- Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation g 5b• 00 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family GY Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes Cho On Old King's H—.way: CisW'(o ' Basement Type: C�'Full ❑Crawl O Walkout ❑Other "—' Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) —+ Number of Baths: Full: existing f new Half:existing ne m Number of Bedrooms: existing�q�_ new Total Room Count(not including baths):existing `7 new First Floor Room Count Heat Type and Fuel: ®'Gas 0 Oil ❑ Electric ❑Other Central Air: O Yes &Ko Fireplaces: Existing I New Existing wood/coal stove: ❑Yes �o Detached garage:O��existing ❑new size Pool: O existing ❑new size Barn:O existing 0 new size Attached garage:C3'existing ❑new size Shed: xisting 0 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-All 0-v t4CA Telephone Number �T D Address �Q_ License# C�A_ v-.v\. S -, - 02ro01 Home Improvement Contractor# Worker's Compensation# -ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOA_Wry SIGNATURE _ �, �eW.,�_ DATE 1 r¢ . FOR OFFICIAL USE ONLY t PERMIT NO. DATE ISSUED ' MAP%PARCEL NO. - ADDRESS• VILLAGE OWNER DATE 6 INSPECTION: FOUNDATION J A 5 FRAME . INSULATION FIREPLACE i ELECTRICAL: RWtfi R1 FINAL m : PLUMBING: ME Q FINAL �! 5 � GAS: R _ m Q FINAL FINAL BUILDING st tz r% 0 "g e:,/dam Ott M O i C © ` DATE CLOSED OUT `+ ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents' .6U0iWashington Street c" J •Boston,Mass.' .02111 . Workers',• Com ensat ion.•Insurance davit-General Businesses ,�-'PC.�eSaR� #., +:d-:t�.c?�`t'e". ..n;e-^'�p,r ''qw.• .;,•,at.71�i§1 name: 1 ( i u Wl address: 8 (9'U,"s �-e- city ti ftiv-v'I; State:' zip: G"O) phone# �1 - .0 cf, 3 3a, 3 work site location(full address):Q G k30-W-,A"\ -C�i r', kilC.t-v2 VL i S. VV\_o-, ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑RestaurantBai/Eating Establishment working in any capacity. ❑Office❑ Sales('including Real Estate,Autos etc.) ❑I am an employer with 'emm, o es(full& art time [ Other /%�%%%%/����1/ %/// I am an employer providing workers' compensation for my employees working on this job.. 1 ..: ' company•iiamet 99. 1I1511ra EjeC 41d:^ L:.y•, ;:v' t>. :K.',.. t• WIT'a sole proprietor Mid hired the independent contractors listed below who have the following workers' compensation polices: c �e amen '•":a...>,:;�`�_ .t' aCx, :'•r'{.;s�. omy nv'n address:. 'i>°'� i: • ' citys.. phone'#.e� - insurance co.'. :.:::=. .;, _ "'o13c # r:a'::�•r:.".'r,'.`'i.+:•.;' _ 7P•;.: •:a.. •1. l'4.•: r company,n -,.i. ;... •..: .. ,: .•,:• .•:• . ' .. •• ..� _ _ :phonE:#: "'��`' �''.;.�'3'' . . . Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civilpenalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that p copy of this statement may be forwarded to the Office of Investigations of the DU for coverage verification. I do hereby certify under the pain s and penalties ofperjury that the information provided above is true and tarred Print name _ Phone# ' ' official use only . do not write in this area to be completed by city or town official city or town: _ permit/license# ❑Building Department - ❑Licensing Board ❑-check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: - phone#; ❑Other (revised Sept 2003) Information and Instructions Massachusetts General Laws:ch4apter�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 mare 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 m.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. /////////D%%%%%/O%%//%%///%////%%////%%%//////////%%%/%�O%///%%%%%////%////////%/////G///////%%%%%/%/f/'%%%%%%%///D%/�i%%%%%//%�%�%%�%%%/%%////�%%%%%%/% Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation.. Please supply company name, address.and phone numbers along with a certificate of insurance as all affidavits may be submitted ccidents for confirmation of insurance coverage. Also be sure to sign and date the to the Department of Industrial A affidavit The affidavit should be returned to the city or town that the application for the permit or.license is being requested, not the Depai-tinent of'Industrial Accidents`. Should you have . questions regazdin�"the"law"or if you are obtain a workers.'.co ensation policy,please call the Depaztment at the number listed.bglow. , required do . lop City or Towns . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to filLin the permit/license number.which will be-used as a reference number. The.affidavits maybe returned to the Department by mail o':FAX.unless other'arrangements have been made. The Office of Investigations would like to thank ybu 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 Blocs of wesugawns 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext.406 Town of Barnstable N °-� Regulatory Services l sasrsrABIA Thomas F.Geller,Director arnss. A sbgq. p1� Building Division TED M Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 . Office: 508-862-40 8 Fax: 508-790-6230 Permitno. Date AFFIDAVIT HOME IMTROVEMMNT 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: (COCA CDC��i �_�-.Estimated Cost . Address of Work: VlI-� S s o 2,C ul Oyvner's Name: ll�G� �. ��e 5� Date of Application: `3`a°� '�' , I hereby certify that: Registration is not required for the following reason(s); []Work excluded by law ❑Job Under$1,000 C] uilding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERNIIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUAp.ANTY 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. 0 wo_� Date. Owner's Name y Q:forms:homeaffidav Town of Barnstable �pF THE tp� Regulatory Services • Thomas F.Geiler,Director BaaxsraBM Mass. ME t639. .� Building Division ArfDMA'l� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: '3, JOB LOCATION: `� ✓"�'d e i r` C.L. y\I-,. number street village "HOMEOWNER': WJ 11 i cm w.u T t'.Q. e.s c.. 1`i 0 g -3 -3 t —1'7 4 7 3 c —3 a 1 name home phone# work phone# CURRENT MAILING ADDRESS: "2.3 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under'the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with.the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official 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 r t a