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HomeMy WebLinkAbout0137 HAMDEN CIRCLE /,37 f/AMIE� P,-cc.c i ,v � = y Town of Barnstable Building . ( i Post This Card So That it is Visible From the Street-Apprioved0lans Must be Retained on Job and this Card Must be Kept wt M•ae. $;r Posted Until Final,lnspection Has Been Made Where a Certificate of,Occupancy,is Required,such Building shal Not 6e Occupied until a Final Inspection has been made Permit No. 6-17-3849 Applicant Name: CAPE COD INSULATION,INC Approvals #_ Date Issued: .11/30/2017 Current Use Structure i Foundation: Permit Type: Building Insulation-Residential Expiration-Date: '05/30/2018 Location: 137 HA'MDEN CIRCLE, HYANNIS - Map/Lot: 291-314 .- Zoning District: RB Sheathing: Owner on Record: WIDENER ANGELIKA Contractor Name:,. CAPE COD IrNSULATION,1NC Framing: .1 Address 137 HAMDEN CIR ContractorLicense,: 153567 2 HYANNIS, MA 0260:1 Est. Project Cost: $4,800.00 Chimney: Description: 3 ,Permit Fee: 85.00 weatherization $ Insulation: Fee Paid: $85.00 q: Project Review Re 1 � •. Final: Date: 11/30/20 7 • Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shalrbe deemed abandoned and invalid unless the work authorized by this:permit is commenced within six months after issuance.'' Rough Gas: 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. Final Gas: . .This permit shall be displayed in a location clearly visible from access street orroad and.shall be maintained open for.public inspection for the entire duration of the work until the completion of the same. Electrical_ Service: The Certificate of Occupancy will not be.issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed.. 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 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 MG c.142A). Fire Department - i . .1 Building plans are to be available on site _ Final: All Permit Cards are the property of the APPLICANT ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Apt/ Parcel Application # Health Division Date Issued ),36)1'2 Conservation Division Application Fee Planning Dept. Permit Fee �S . Date Definitive Plan Approved by Planning Board Historic - OKH. _ Preservation / Hyannis Project Street Address Village Owner ,Ag Address�X/L, Telephone f'_0 P1 77jJ/// Permit Request /2 8 v�,��e���/�r� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 4�A.o y Construction Type_��f/v�i/�,9��� Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting-documentation. Dwelling Type: Single Family A Two Family ❑ Multi-Family(# units) `= Age of Existing Structure Historic House: ❑Yes A No On Old King's Highway: ❑Y,',es No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Otherco Basement Finished Area(sq.ft.) Basement Unfinished Area (sq!ft) Number of Baths: Full: existing. new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ 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 &.,o Telephone Number 5,W77�ZJ V— Address f ✓G��:9)2,-)o z,/ ('l te, License # _A4/,9 V/-7'-a'J0'eUe* Home Improvement Contractor# /'d'3� Z Email41/ c 4&? r� C��//�fU� akPs 60*orker's Compensation # �LYl Z ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO / z SIGNATURE DATE ,�/ b6 T FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 'The Commonwealth OlMassachusetts Department of Xnduslrlal Acclde�rts 1 Congress Street, yl?lte 100 Boston, MA 02114-2017 Www.mass,gov/dla Workers, Compensation Insurance Affidavit: Builders/Contractors/Electrlctans/plumbers, TO;BE FILED WITH THE PZPMfT I1X0 AtlTKOIUTY, Applimpt r le se p Name (Buslnessl0rganizadon/Individual); Cape Cod Insulation Address; 18 Reardon Circle City/Statellp;' South Yarmouth^ 02664 Phone #r 508.775-1214 Art you an employer?Check the appropriate bort lQI am aemployerwith 48 employees N Type of project(required), ( II and/or an•tima ,e p 2,❑I am 11611 proprietor or partnership and have no employaes.working forme In 7;' [].Now oonstruodon any oapaolty,(No workers'oomp,iruumnoe required,) 8, ❑Remodeling 3,❑1 am a homeowner doing M work myself,-(No workers'comp,Insuranos requirad,)t 91 Demolition a,❑1 am a homeowner and will be hiring contractors to oonduot all work on my property, I will 10 [] Building addition ensure chit ul oontraotors either hays workers'oompsnsatlon insurance or are sole proprietors with no employees, 11,❑ Elootrioal repairs or additions' S.❑I am a general oontrsaotor and I have;hired the aub•oontrectorslisted on the attaohedsheet, 12,❑plumbing repairs or additions These sub•oontraoton have omployess acid hays workers'oomp;Insuranoc,s 13, Roof repairs 6,❑We are sootporm*n and Its offloere have exerolsed their dghtof tmmpdon per MOL o, 14,[7,/ Other Weatherizadon I52,11(4),and we have no employees, (No workers'oomp,insuranoe mqulrcd,) :Any sown ens that cheeks�x#1 must also fill out the section below showing their workers'compensation polloylnformation t Homeowners who submit ti!'rdavit indiaating they ere doing all work and then hire outside oono•aotora must submit a new aPtidavlt lndloedng such tContraotorr that check this box must attached an dddidonal sheet showing the name bf the sub•contraatori and state whether or riot those enddes have employees, If the sukontnotors lays emplo cos they must rovlde their workers'oom , lloy number, 1 am an employer'rhal is providing workers+ oompensallon Insurance for my employees, Below!s the policy and o ! dnJormatiort, p cy ! b s le Insurance Company Name; Atlantic Charter Policy or Self ins,Lio,#; WCE004 31.902 BXPIrat(on Date, 06/30/2018 Job Site Address; Attach a copy of the workers',00mpensatlon po icy declaration page(b owingltylhSetatoe/Zip;�yj_ Failure to secure oovorage as required under MOL o, p licy number and expiration data), "-;,and/or one•year imprisonment, sas well as aivll Penalties In the form of a STOP violation pRb��le by a flea up to$11500,00 day against tha violator, A copy of this statement may be forwarded to the Offloe of Investigations of d 4 tine of up r I saran 0 a covsrage verlHoatlon, the DIA for Insurance 1 do hereby ee under p its and penalties oJper�ury that the 14formatl0n provldgd above is true and correct, r � Ma YIIiV wW��JIW 4Ml�YWIWµwN4NtMli1 50 75=1214 r 7131stuling only, Do not write In this urea, to be completed by city or town or Towns Permlt/Llcense Authority(circle ones 1, Board of health 2, Building Department 3, Clty/Town Clerk 4, Electrical Inspector', 5+ Plumbing Inspector 6, Other p Contact Persons phone#s • Massachusetts Department of Publ{c Board of Building Reg ulation and .Safet y License: CS-100988 Standards Co nstructlon Supervisor HENRY 8 SHED RpWS8ID.Y,, `•, " WEST YARMOUy H f 2' Commissloner Expiration; 11/11/2017 Cam/ i� - Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston, e Ma , b usetts 02116 11 Horne improvem .gt�o ;tractor Registration Type: ' Corporation Cape Cod Insulation, Inc r., ''{ -w-~_ r Registration: 153567 18 Reardon Circle =L��.3.y;,t} -`: a Expiration: 12/14/2018 So, Yarmouth, MA 02664 SCA t {) Update Address and'return card, Mark reason for change, _._.. .._---h��A�lr! ss a_1 n ap e WoorUr�zoozcuealt�o rt3lJ[)1;1 —,F �1C3`�M3r1� -\ y��/L�auouc�ccaeCta Office of Consumer Affairs&Business Regulation Corporation HOME IMPROVEMENT CONTRACTOR T Registration valid for Individual use only d ype; before the expiration date, If fours urn'to; .f3eaistratlon Expiration Office of Consumer Affairs and si ss Regulation 12/14/2018 10 Park Plaza- e 5170 g -fj 1" f::ai. Boston,MA 11 Cae Cod Insultioll;l L. He'nryassldmouth,MA�Q264,�; �� V Undersecretary - t al hout sl atu AC 0" CAPECOO.27 YL L.._.� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D.ONYYY) 06/30/2017 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 p011cy(les)must have ADDITIONAL INSURED provisions or be endorsed, If SUBROGATION 13 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 a , PRODUCER E(PAC, ACT Rogers 8,Gray Insurance Agency,Inc, NE 434 Rte 134 No Ext; ac No; 877 816.2156 South Dennis,MA 02860 mall ro ers ra ,com R S FF 01 E �NAIC s ER Peerless Insur nce Com an 24198 INSURED RE :Safet In uran s C m an Cape Cod Insulation,Inc, 39454 _ 18 Reardon Circle ER c Endurance America Speclalt' Insurance Company 41718 South Yarmouth,MA 02664 INSURER t):AtIanfIr Charter Insurance Company 44326 INIURERE• INSURER F; COVERAGE$ Id, E BE ; 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 SUER TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP A X COMMERCIAL GENERAL LIABILITY LIMITS CLAIMS-MADE OCCUR CBP8263063 A HOCCURRENCE 1,000,00 04/01/2017 04/01/2018 D—AGE T Y,RENTED 100,00 M DEXP(Any o n 5100 EN'L AGGRE TE LIMIT AP ES PER' 2--ERSON6L&AOVINJURY 11000,00 X POLICY P LOC _Q9NERAL AGGREQATE 2,000,00 OTHER: OMPIOP A 2,000,00 AUTOMOBILE LIABILITY COMBINEnn CELIMIT 11000,00 22NY ED 6232707 COM 02 s AUTOS ONLY X SCHEDULED 04/01I2017 04/01/2018 B ILY INJURY Per Person) ff AUpIT�OpSwNEp X AU ONLY X AUTOS ONLY BRDILY ITN RY P r accident) P�accRdenl AMAGE C' UMBRELLA LIAR X OCCUR X EXCESS CLAIMS-MADE EXC10006636002 04/01/2017 04/01/2018 EACH ° RRENCE 2,000,00 OEO RETENTION$ RE 2,000,00, D WORKERS COMPENSATION AND EMPLOYERS LIABILITY X PER OTH• ANY PROPRIETOR/PARTNER/EXECUTIVE R/O WOE00431902 08130/2017 08/30/2018 FILE rMEMge)EXCLUDED? N� N/A :tDISN�IPTION 3 doorylnNnd L.EA HA I E 1,000,00( descrlbaunder E DISEASE-EA EMPLOYEE 1,000,00( RA I N elo L.bl EASE•p LI LIMIT 1,000,00( DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more epeae la required) Workers Compensation Includes Officers or Proprietors. Additional Insured status Is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certlficate Holder, 7196,Cranston, OLDER 10 SHOULD ANY OF THE ABOVE BE lach Engineering Inc, THE EXPIRATION DATE THEREOF,E NOTICEEWI LOBEODELIVERED BEFORE DELIVEREDFrances Avenue ACCORDANCE WITH THE POLICY PROVISIONS, RI 02910 AUTHORIZED REPRESENTATIVE ACORD 26(2016/03) ` The ACORD name and logo are registered m©sgof ACORD CORPORATION. All rights reserved, HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. doo Af A661",�A herebyconsent to and agree that weatherization work 9 may-be done by the.Weatherization Program of Housing Assistance Corporation on the property located at: Afi`f The weatherization work done will be,based on programmatic priorities and availability of . funding and it may include all,or some of the following measures: Weather stripping; air`seaiing;attic & basement insulation; exterior wall insulation; ventilation measures In consideration of the.weatherization work to be done at my home I agree to the following: 1. I give permission to Housing Assistance Corporation the property with such equipment and materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five(5) years after the- weatherizationwork is completed. have read the provisions of this agreement and give my.consent.. Home Owner(Signature) ,+L ; : �' - -1 ( :,• l [ G2 7 d Home Owner email: Date: Agent:(signature), Date: Weatherization_Contractors: Adam.T Inc. Cape Save All Cape Energy Frontier Energy Solutions Alternative Weatherization . Lohr Home Improvement Building Science Construction Resolution Energy Cape Cod Insu anon Tupper Construction Details Page 1 of 1 Licensee Details _ ........ ..... ................................. ......... ........ ........................................... Demographic Information Full Name: HENRY E CASSIDY caner Name: License Address Information City: WEST YARMOUTH State: MA ipcode: 02673 Country: United States License Information I icense No: CS-100988 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 10/31/2017 Issue Date: Expiration Date: 11/11/2019 License Status: Active Today's Date: 11/30/2017 econdary License Type: Doing Business As: tatus Change Reason: Prere uisite Information No Prerequisite Information 1 http://elicense.chs.state.ma.us/Verification/Details.aspx?agency_id=1&license_id=28998... 11/30/2017 G i .; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ' Application Health Division / Date Issued <<l (C7 Conservation Division Application Fe Planning Dept. Permit Fee' Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address et, Village r Owner 14 ' (�RO� v�� Address �� T t�i Telephone Permit Request , lG c _*r - Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 'roject Valuation • Construction Type- CD Lot Size '° Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family. ❑ Two Family ❑ Multi-Family (# units) l ` ' Age of Existing Structure n Historic House: ❑Yes .2�No On Old King's Highway::❑Y6�'-' ❑ No Basement Type: ;Full ❑ 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: 3 existing —new Total Room Count (not including baths): existing S new First Floor Room Count Heat Type and Fuel: U Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing XNew Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing 0 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 -- APPLICANT INFORMATION ��NL PGI soy f2 (BUILDER OR HOMEOWNER) 14:00 Name4 ° Telephone Number ���� 02-- Address WI -+mot License # t S 026 O Home Improvement Contractor# Worker's Compensation # r ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE G DATE `I' l '0 t ' FOR OFFICIAL USE ONLY APPLICATION# •DATE ISSUED t ;MAP/PARCEL NO.- -ADDRESS VILLAGE OWNER DATE OF INSPECTION: r 1 FOUNDATION) FRAME s ate;,INSULATION,. ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL y ' ?€GAS: -` ROUGH '=> xU;,k zl, FINAL FINAL B_UILDING'K D 'G:° r ;DATE CLOSEUIOUT. x . i i ASSOCIATION PLAN NO. Th.e Commonwealth of Massachusetts Department.ofIndustrialAccidents , (' Office of Investigations 600 Washington Street l Boston, MA 0211.1 yy. www,mass.gov/die vit: Builders/Cont'ractor,s/Electricians/Plumbers Workers' Compensation Insurance Affida A licant Information Please Print Le ibl Name (Business/Organization/ ndividual): ' Addrcss:_C�7 Qic - nn . . i /State/Zi : W j �o Phone C .. P Are you an employer? heck the appropriate box: Type of project.(required). 1.ElI am a with employer 4. ❑ I am a general contractor and I 6. ❑New construction *.,., sub-contractors'.., ;_ _. _ .:-:_-: .. ...... . employees.(full and/or part-time). liave`hired the 2.El am a sole proprietor-or partner- listed on the attached sheet. 7. ❑ Remodeling These sub-contractors have g; ❑ Demolition ship and have no employees employees and have workers' working for me in any capacity. 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑-We area corporation and its ME] Electrical repairs or additions 3, ] I am a homeowner doing all work officers have exercised their 11.[].Plumbing repairs or additions comp. right of exemption per MGL 12.❑ Roof repairs myself. [No workers insurance required.] t c: 152, §1(4), and we have noTM„ employees: [No workers 13.❑ Other comp:insurance required.] ' *Any applicant that checks box C 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 erriployees. Below is the policy and job site information Insurance Company Name: Policy#or Self-ins,Lic.#: Expiration Date; Job Site Address: City/State/Zip: Attach a copy of the workers,' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required.under Section 25A of MGL c. 152 can lead to the.irnposition 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 in coverage verification. , I do hereby certify under the pains a d penalties of perjury that the biformation,provided above is true and correct. IAA Vtf 1, Date'. S- V Si nature: # `Phon'e .. : ,. . Official use only. Do not writ,e in this area, to be,compleied by,city or town Official City or Town. : Permit/License Issuing Authority (circle on 1,Board of Health 2. Building Department 3, City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Phone#: Contact Person: information: and fnStructzons 'd Massachusetts General Laws chapter 15.2 requires all employers topr oy In iheservio kceof another th Linder o es. any contract hire, Pursuant to this statute, an einployee is defined as ",_every person express or implied;oral or written." orany her gal entity, An employer is defined as "an individual,partnership, ding the legalle al rreepres'enl repron or esentatives of aedeceased empl yer,ootheore of the foregoing engaged in ajoint enterprise, and including g P 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 aparCments and who resides therein,.or the occupant of the air work dwelling house of another who employs persons to do maintenance se of sucth�emoloymenor rept be deemed ed to be a n Such el nempl employer." house or on the grounds or building appurtenant thereto shall not because P L MGL chapter 152, §25C(6)also slates 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 acceptable evidence of compliance with the insurance coverage require appli cant who has not produced d." , ) state s "Neither the conunonwealth nor any of its political subdivisions shall Additionally,MGL chapter 152, acc enter into any contract for the performance of public-Work until acceptable evidence of compliance with the insLrrance requirements of this chapter have been presented to the contracting authority. Applicants Please.fill out.the workers' compensation affidavit completely, by checking the boxes that apply eir to your situaA on and, if necessary,supply sub-contractor(s)name(s), addresses) and phone n� O g h insurance, Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the oes have members or partners, are not required to carry workers.' compensation insurance. If an LLC or LLP d employees, a policy is required. Be advised that this affidavit may be sb nidid to the affidavit o thntThe affidavit of lshould Accidents for confirmation ofinsurance coverage, Also be sure to sign own that•the application for the permit or license is:being requested,not the Department of be returned to the city or t Industrial Accidents. Should-you have any questions regarding the law or if you are required to obtain a workers' compensation policy;please call the Department at the number listed below..Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has,provided a space,at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the.permiUlicense number which will be used as need only number. In affidavit nnd.icat an p�g,currrtent that must submit multiple permit/license applications in any given yea , Y (city or Policy information (if necessary)and Linder"Job Site Address" the applicant should write"all locations in town)."A copy of the affidavit that has been officially stamped or marked by the city.or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses; A new affidavit must be filled out each er or citizen is obtaining a license or permit not related to any business or commercial venture year. Where a homeown (i,e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of lnvestiga[Ion� . e t0 thrt_Y1[YU_i`G-advaRCe_0T y_9u_r_CQ0pera6Dn.and should you have any questions, please do not hesitate to give us a call. The Department's'address, telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston MA 02.111. . Tel. 4 617-727-4900 ext 406 or 1-877-MASSAFE Fax 4 617427-7749 Revised 4-24-V www:lnass.gov/dia 4 Town of Barnstable �oFY�toyer .. o Regulatory Sei yices ,-r,kB Thomas F. Geiler,�Director BARNLF- MASS - .. � t639 time Building Division ArFD Tom Perry,Building Commissioner 200 Main Street,...Hyannis,MA,02601- www.town.barnstable-ma.us - Office: 508-862-4038 Fax: 508-790-6230 HOMMOwNER LICENSE EXEMPTION Please Print '. DATE:T�� V ,mil nn )� ! ,4 JOB LOCAMN: �N A e L4. l.(1r � otvl 1 l S mp S�)�^Q���le ' number 11 strcot village 1`�(y(�d "HOMEOWNER': ot4 Dlit [Q( . ✓�� Via - �tJ�-771 'oola name _ home phone work work pho c# CURRENT MAILING ADDRESS: ;ty�UwD - state - - - zip code The current exemption for"homeowners"was extended to include owner-occupied dwellifigs 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.snuctures accessoryto such use and/or fairs 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/sbe will comply with said procedures and re ements. . • /1 /t 0 Signatiir f Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required t.D comply with the' 'State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that' "Any homeowner perfoiining work for which a building permit is required shall be exempt from the provisions of this section_(Section ID9.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages.a,persons)for hire to do such work that such Homeowner shall act as supervisor.". Many homeowners who use this exemption are unaware that they an assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for'Licensing Construction Supavis6rs,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 ultimatc)y responsi'ble. :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:forrtns:homcexcmpt 3 ;a TErti Town of Barnstable Regulatory Services sAxMkS& .� F Thomas F. Geiler,Director v� 1 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230. Property Owner Must Complete and Sign This Section , If Using ABuilder r,r I, /Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work autho y this buildin ermit application for. (Address of rob) Signature of Owner Date Print Name If Property Owner is applying for perrmt please complete the Homeowners _License Exemption Form on the reverse side. Q:F0 MS:0WNERPERMISS10N EMO M MEN MENEM so ON 0 ME ME 0 ME ONO ONE ME NONE NNE MIN MEMO No 0 OEM ME 0 OMEN ME F I B. F d --;- - 1---, -;-----:- i i-- � i� I i I ► j I f . � , ! i i .I T \ i 1 �•�..1.. 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I Iit 1 i I I I I I F H I 1 e I � I � a i .' ��� � ' "' � . � � T ,+ p 0 i �. Map .^ Page I of I Town of Barnstable Geographic Information System New search Home I Help Parcel Viewer Custom Map Abutters Map Size ® Zoom OufE 0L M E I JI Turn map layers on/off by 3PG selecting check boxes below t- '.,.F Town Boundaries - r F Road.Names Voter Precincts r ^^ k ¢ _ Map&Parcel Numbers, Parcels "r,.FEMA-Q3 Flood Zones(Old Maps) - 1 Will be Superceded in 2030 - a AE(100 yr flood) 100 yr flood I VE(100 yr Flood w/wave action) - X500(500 yr Flood) _ "• "r. P Neighboring Towns �.Water b 0 __4 _Eee.t Y @," M r Streams Set Scale 1" _.0 I Aerial Photos- I MAP DISCLAIMER" r ' - Copyright 2005-2010 Town of Barnstable,MA All rights reserved:Send questions or comments to GIS - ' HarnStableMA 0.2.3685[Production] a ' t http://66.203:95.236/areims/appgeoapp/map.aspx = ?propertyID291314 ^ 7/9/2010 . I 1NE Tn ti Town of Barnstable - HARN3fABLE, + M11A83. �,,, t6J9• �m� Assessing Division lEDN50y� 367 Main Street, Hyannis MA 02601 Office: 508-790-6215 Robert D.Whitty FAX: 508-775-3344 Director of Assessing January 29, 1996 Mr. and Mrs. Robert O'Donnell 20 Harbor Road Hyannis, MA 02601 RE: Split Request- Lots 7& 8 on Carl and Warren Avenue, Hyannic� _ — ParcelID: R306-177 ,� C�lieL 7+0�- y 3d� _,�7 Dear Mr. and Mrs. O'Donnell: . We are in receipt of your correspondence dated November 22, 1995, relative to your request to split the above-referenced lots into two buildable lots. We have reservations about processing your request to divide the two lots. Each lot by itself may not be a buildable lot. Barnstable's lot size requirement is one acre (43,560 square feet). If divided, the assessment on both lots may be considerably higher; however, the zoning ordinances would most likely prohibit your lots from being buildable separately. Please contact Mr. Ralph Crossen in the Building Inspector's Office or call him at (508) 790-6227 with regard to the buildability of these two lots. 'Upon receiving a determination from Mr. Crossen with regard to the above, please advise this office if you wish us to proceed with your request. Sincerely, Robert D. Whit:ty, MAA Director of Assessing RDW:jps cc Mr. Ralph Crosser * ✓ P Assessor's ma and lot.-number '� SEPTIC SYSTEM MUST BE -. SewF INSTALLED VN COMPLIANCE age Permit number %r 1 .. ......................... ... ............... r` T WITH.ARTICLE II STATE �7NEt 00� `� � r GODS AND TOWN o TOWN OF BARNSTA �NS. __--_- _ 9O MA86..F 0 V c': r BVI.LDIRG I I�H S P E C T 0 R (A APPLICATION FOR PERMIT TO :.............:..... .: ........................................ . .. *. �] TYPE OF CONSTRUCTIONlC�:•i,r•*,�.• � ../.0.7777:�v...........19.�'�...7 TO THE INSPECTOR OF BUILDINGS: 4#11 „ The undersigned hereby applies r a permit according to the following information: Location ......... ' Proposed Use �l ' ................................... ZoningDistrict ...:................................................. .... ..............Fire District .............................................................................. Name of Owner : ...: Address ...... i Name of Builder .. .Ae,' .q.: «L�i v 4 f � 'r�� r ........... s ................ Nameof Architect ..............:..........: .......................................Address .................................................................................... Number of Rooms ..................... ... y............................. .r6.1,111'.......5.......f:l.C..(„a.���. ... Exterior ... .. ...� d... J.l g ......... .. ....Roofsn ...r. ... .. .. .. .. . Floors /..'.� `...... ...................................Interior ...... . • Heating .. .. .L �...d..�: .....C�S Plumbin .. .. .......� zL.......................... fireplace ...................�..lvr............................................Apprdximate. Cost ........., ..GP.f�. .................. Definitive Plan Approved by Planning Board ___ _ ---------- -------- Area !. ..� 1 S• m� Diagram of Lot and Building with Dimensions Fee w SUBJECT TO APPROVAL OF BOARD OF HEALTH t I 6 xxo &VV I hereby agree to conform to all 2 Rules and Regulations of the Town f Barnstable regarding the above construction. Name .. ex'a � �r • ' Theoharidis, Spero No /#�.�Permit for Sin$ a Fsmil , .......................... ............Dwelling.................... Location .bot.#97 137 Hamden Circle Hvannis i Owner ...Cedar Acres Realty Trust 7 _ ......... ..Wood Frame Type of Construction ..............................:........... ...................... .............................. e ... .......... / `,, +r. �, ' ..f r .,, ;ram. • .� . Plot ............................ Lot ................................ Permit Granted ............:Feb....14...:. 1978 ter^ 'r ��� _ y✓'� - - Date of Inspection ....... ...'19 4 Date Completed ......19 PERMIT REFUSED _ .......................................................... ... 19 �f ......................... .: ..................... ........ }.. ................................ .... r < .`+e• ....... .................. ...�.......... �' �f J ' Approved ..................................... 19 ....................................................... j f THE TOWN OFBARNSTABLE a M BUILDING INSPECTOR TYPE OF CONSTRUCTION ... . TO THE INSPECTOR" OF BUILDINGS:= The-undersigned hereby,,applies-for a permit according to !he following information: Nome of - , v==. `�^ ...... .....`.'`^..�c^f�o�+w�_� � ^� Nome of Builder —!�]��l�� /����/«»m ,J �S� _ �^�^`��^*�'m'' ' ''i�—f'w�o �» ----'' —��^ ' �'������'��� .. ............ ^ - ` Nome of Architect .......................... -------------A66nss -----------------------.----.. � Number of Rooms .��----------.Foundation . Exlerior '�^0/���.��^y-x�^_f _ ....Roofing ___ ' Floors -- / ............................|n��icv ---. _______.. Heating .���/�����������kf��~�.1^! '/�.'��'�--F1um6ing ---'. ��X��-----�.—.� /7 Fireplace ................... ----~----------.Approx|mote Cox ........ . ................... Definitive 6v Planning 800nj l� � �� � ' "pp "~=^ . �� *n*o —..���/�z����---..'..�, � Diagram of Lot and Building with Dimensions Fee __________.�'�-�_'_ ' -' SUBJECT TO APPROVAL OF BOARD OF HEALTH ' yet I hereby agree to conform to all the Rules and Regulations of the Town.of Barnstable regarding the above ` � � ~__ Theoharidis, Spero No �99?- Permit for ....Single IDamil�r Dwelling ............................................................................... Location L.a.097 137 Hamden Cir ................. ...........Hyannis.............................. 9 Owner Cedar Acres Realty Trus.t........ ............. .... .... Type of Construction Wood Frame .......................................... ............................................................................... Plot .......................... .. Lot ................................ Permit Granted ......Fe-b.-.,,..14..........................................19 78 Date of Inspection ......................................19 Date Complete .......................................19 PERMIT REFUSED .................................. . ................... 19 ..... ............. ... .. .. ..................... /v . ...... . .. .......... ........... ................................................................... Approved ................................................... 19 ............................................................................... ,CaT36 • 9y73 . .-a r3�'� � /0 33 o., '� d• q 6x �s r. � � v n ~AMA*&V w , T=35'. d8-GD NA�lD.CAl C/Z. G: Gl v� [i v LG . . S L,r. f} C7 PL 1-- 1V SI-1,0Gt I /6G r 4 h- ik • .yDC1S� .CI�Cf��'"✓a.�1/ . � . M1 , ` �•�, - No,t�MAN rrP,OSSMAN Z-1• S. 53s ,o9e-I-Ce.7— c oln I*eo 9 !;ISTANT TAX COLLECTOR COLLECTOR I'I)TY TAX COLLECTOR r - Q LERK ISLIS/VOTER ADMIN ISTANT TOWN CLERK ECORDS MGMT CLERK+E311 NN CLERK NSING ADMIN-RECORDS CLERK ORDS CLERK a U 11i+L5 � r_k@ w Iq 0FFICIAJ< USE t~ C Postage $Ln C3 Certified Fee C3 Postmark Of C3 Return Receipt Fee Hgrg_ (Endorsement Required) -i O Restricted Delivery Fee C3 (Endorsement Required) C3 rl , Total Postage&Fees PS fl.l C3 Sent To ......Apt.- ` [ti Street N. or PO Box N -_ -----•---------- City,State,ZIP 4 --'--------- Certified Mail Provides: o A mailing receipt o A unique identifier for your mailpiece , o A signature upon delivery o A record of delivery kept by the Postal Service for two years Important Reminders: V n Certified Mail may ONLY be combined with First-Class Mail or Priority Mail' ,r-' , o Certified MalU1�'sn¢tzailable for any class of international mail. a NO<INSURANCE'COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For any additional fee,a Return Receipt may be requested to provide proof of delivery. r1, n Receipt service,please complete and attach a Return Receipts„ _ rm 3e1`9?to the article and'add applicable.postage to cover the fee.Endorse mailpiece 'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS postmark on,your Certified Mail receipt.is regwred. r o For an additional'lee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Form 3800,April 2002(Reverse) 102595-02-M-1133 ! ai SENDER: r I also wish to receive the v ■Complete items 1 and/or 2 for additional services. following services(for an y ■Complete items 3,4a,and 4b. a) ■Print your name and address on the reverse of this form so that we can return this extra fee): .N card to you. v d ■Attach this form to the front of the mailpiece,or on the back if space does not 1.❑ Addressee's Address permit. 2.❑ Restricted Delivery d d ■Write"Return Receipt Requested"on the mailpiece below the article number. ry N t ■The Return Receipt will show to whom the article was delivered and the date delivered. Consult postmaster for fee. o 0 rD 3.Article Addressed to: 4a.Article Number .t 4b.Service Type � tc �: /�� /�/ ^ ,� ❑ Registered Certified � � l '�I�/ 0 Express Mail n�sured !aj eturn Receipt �chandise OD 3 a 7/Date of Deliv ry �` 0 3 O M 5.Received By: (Print Name) 8.Addressee's A d (Only if re ted Y and fee is paid W t H 6.Signat e: (Addres eeA eent) ��� �, X lJvll��dt 'I( 2 PS Form$ 1,DecembWr 1994 102 5-9a-s o229 Domestic Return Receipt UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid uSPS Permit No.G-10 O Print your name, address, and ZIP Code in this box i i y��/�/� ��� ���i��E'.1�• i'�f:flfl:li�tli�;.falil7,F� e . „ k .�rt r ,,;ah ta— _•.�:. „t.,�.+a._. r 'S rM1t'1"..,} "e '..-. .?.^'—rai"r,'f a �" ~TOWN OF BARNSTABLE a BAR-W. Ordinance or Regulation WARNING NOTICE Name of Off ender/Manager / ., � f.. ,} .,q # .' , Address of Offender , WA.tsra AQ, MV/MB Reg.# Village/State/Zip Business Name am/pm; on 20 03 or Business Address „� , �, Signature 'of Enforcing Officer Village/State/Zip Location of Offense f_ ') flp,7� � w4, r- lie e 4 Enforcing Dept/Division 0 f f ense. .a=/o+ 5' ej-l zi /o c x c. ` «" .. ,t" <7-we k i >e 4 u.or Facts tv/" ra r. rt s t3 /. /,,. 1el 1),4y 4 a re ',�f 0t` � �.� S. � �yr 1♦ .T �F�T'+ �X T T W ! .If,N'.r' ♦ /'. rf` d`'°.F /� �F.' R R"z �/r� .9�1 _ This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY.-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.