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0292 MAIN STREET (HYANNIS)
l 14) o Assessor's Office 1st floor MaD, Lot 1 Permit# �jr 7 yy 7 Conservation Office 4th floor) 9 jr Date Issued ; X Board of Health Ord floor '�U ' h gat lu' >CEn ineerin De t. 3rd floor House# � Planning bept. (1st floor/School Admin.Bldg.): KAM . � Definitive Plan Approved b Planning Board 19 %679. PP y !; ° (Applications processed 8:30-9:30 a.m. & 1:00-2:00 p.m.) AMCAMN am CONNECTION PERMIT FBOM THE ENGINEERING DIMMON MOR TO CONSTRUCTION. TOWN OF BARNSTABLE Building Permit Application Protect Street Address '�' :S Village // Fire District Owner / s// .LA/1? Address Gh� Tele honc Permit Request: 01A C , / 44 tigs Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Anneals Authorization Recorded Current Use Proposed Use Construction Tyne Eaistinp-Information Dwelling Type: Single Family Two family Multi-family Age of structure Basement tune Historic House Finished Old King's Highway Unfinished Number of Baths No. of Bedrooms 1 Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name 81 I' S nly ST U eTi 0' / Telephone number Address CP7, / License# OZ, N C?' C S Home Improvement Contractor# sle Worker's Compensation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Project Cost a% Fee 61;rlOy SIGNATURE �%�7 Q DATE Al'u BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T �37 FOR OFFICE USE ONLY r 2/.23/95 327.255 ADDRESS 292 Main Street VILLAGE Hyannis l OWNER William T. Clarke DATE OF INSPECTION: ^! , FOUNDATION' FRAME INSULATION 1 FIREPLACE ) ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r < FINAL BUILDING: C.rW _ ! 6c / DATE CLOSED OUT: ASSOCIATE PLAN NO. �!� ' 11/02/9 4 17:02 V617 7277122 DEPT IT'D ACCID 0001 - rTc Cotjunonu.uea t{i o Waljac{zu�eth �aPartine►tE o�J'•ndu�triaC,./Hcci�n� 600 W ulti►glon�ht l James J.Campbell Uo1Eon, Mmac Commissioner Workers' Compensation Insurance Affidavit 1, A, with a principal place of business at: C3/7 r- b Lise �ccyis z1v) do hereby certify under the pains and penalties of perjury, that: I am an employer providing workers' compensation coverage for my employees working on this job. ",91qy 6,6, a�e sylr insurance Co pany o e Yoe Policy Number () I am a sole proprietor and have no one working for me in any capacity. () l am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor insurance Company/Policy Number () I am a homeowner performing all the work myself. I u;!der<_tard t`:t z copy of Chis s:ztement will be fone.zrded to the Office of Investigations of the D1A for coverage verification and that failure to secure ccverage as rec;-.ii;ed under Section 25A of MGL 152 can lead to the fmposition of criminal penalties consisting of a fine of up to S 1,500.00 and/or cre yews' impri<orm„ent.s well as civil penalties in the form.of a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this day of )CI n'tat 19 �f , � � 1 ,. Licensee/Permittee Building Department Licensing Board Seiectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE BUILDING PERMIT # ylj'7 `-� COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE MASSACHUSERS BOSTON,MA 02166 Q� LICENSE EXPIRATION DATE 13943 CONSTR. SUPERVISOR CAUTION 9/0 2/ 9 S RESTRICTIONS EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST NONE 06/30/1993 004572 THEFT, PUT RIGHT THUMBPRINT IN APPROPRIATE D A V I D S HILL BOX ON LICENSE. z 317 BUAKERMEETINGHOUSF Z F SANDWICH PA 02537 BLASTING OPERATORS m m MUST INCLUDE PHOTO. PHOTO(BLASTING OPR ONLY) F7 b 0. C NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER � { E, THIS DOCUMENT MUST BE CARRIEDON THE PERSON OF "SIGNIT LICENSEE SIGN NAME IN FULL ABOVE SIGNATURE LINE THE HOLDER WHEN EN- OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATION. §/' �y - Co ON l s4e, 1,A r^ W�,IdAM P. c � Ph t4 Pros W r FeeT 10" Sol* TUBC 292 Main St., Hyannis, MA n02601 • 508-775-2552 LC llld� •. ��.` � ,``i ��9 37 jai yam, _ .. • { i"' ,te r ` 14 :.f. �L,.L , t w; :-- -. A; • - . . I. . � . \ ' p< %.•AO v t-.:. .' a rt. ff,• . -e to, ' '` .. �. .. ..-t_. :}, �f cam.:.-,%:._.. .. .. ..,74, I. +;1i',`�i',.y : . . ,a A s�.t. .`� ;fy.• :.`eA4. ,cam' •� a 4 .°s: ,I +q I s r - Y v _ f .yam, . 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'y'blJ� �7 : . . �` . . 4b6 a _ 1` : C_<'• 1 ,:' 7 . 4 • �`��� ,�' �cc�, !� �'o,f � °� . � �� l µ , �, t Y — P�OF7HETD�y TOWN OF BARNSTABLE 24 s BABBSTMM o° 9'°iOI�Ce pY p�'�� Off ice of the Building Inspector April `413, 1934 PERMIT TO ERECT SIGN IS HEREBY GRANTEDTO ......... ��r�car, �•t..1 „;r ,�,xfa.L. ........ .... . . . . ........ ..... . ........................................... a. LOCATION 33.jj���� ... JAL L'.4G�b 6Z s7ti��`Z.sw��1r. ,.. ,. r... -. ANY VIOLATION OF THE SIGN LAW WILL CAUSE IMMEDIATE REVOCATION OF THIS PERMIT i wilding Inspector TOWN OF BARNSTABLE 1e7o 3 , SIGH APPLICATION FWTY�L IZ. IgjY Owner's Name Address7°'"" Location �/�5 i E'7-J _ FTVS�z__EW '1)UVg6rQ PAft(z 01 AC +-- MOB l i-Lt-SCS •-� �� Y Name of $vifdLr Sr n 11,14Ce.-r — hQ� V Ve& T i /1 Ci cn 3 fpo r /c c� . Address � /-f�Q --Ij( � ISO , 0,74 ✓t i 5 3 Type of Construction j � v°('�c dt y x �� C-,oY K!!�f - Ca Y'V e- j d�7/i J Free Standing or Attached A-17-7 ACH-C-D S I LCZ f3A-rJ)D -r A-7-FnCN3-cJ& /4-7qRDuq4,R _ Zoning District Fire District I hereby agree to conform to all Rules and Regulations of the Town of Barnstable regarding the above construction. All permits subject to approval of the Inspector of Wires. �. Name Diagram of Lot and Sign with Dimensions to be placed on re se side. . a b A V J L µ Page 1 of 1 - s NAI the fire district out their to take a look. Let me `vn.barnstable.ma.us>; tan@town.barnstable.ma.us> i � Town of Barnstable Building PostTh,is Card So That rtxis Visible<From the Street:�A roved.Plans Must be<Retamed on J.ob and thisCard Musi be Ke t :r MrW3YABt8 • 'v ws. «3 '`° ,� ` nrAs® :. ntil�Final Permit p ;Posted U„ pection Has Been Madam. ° Where a-Certificate of,Occu anc is Re aired such Bu ldm shall Not be.,Occu ied:unt�l a Final Ins ection,has,:been:.made Permit No. B-18-962 Applicant Name: JOSHUA X KOURI Approvals Date Issued: 04/24/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/24/2018 Foundation: Location: 292 MAIN STREET(HYANNIS),HYANNIS Map/Lot 327 255 Zoning District: HVB Sheathing: Owner on Record: CERICOLA,SARAH J&RAYMOND C ContractorName ,,CAPE& ISLAND CONSTRUCTION Framing: 1 CO, INC. Address: 33 LORENA RD 2 All Contractor LicenSe 165936 WEST YARMOUTH, MA 02673 Chimney: Description: strip existing front facade. install 3 new retrim&resitle Est Protect Cost: $54,900.00 ` Insulation: Fee: ,g .Permit $ 160.00 Project Review Req: z Fee'Paid: $ 160.00 Final: [date: 4/24/2018 _.. Plumbing/Gas }` Rough Plumbing: Final Plumbing: Building Official Rough Gas: offist > > This permit shall be deemed abandoned and invalid unless the work thori auzed by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application"and the approved construction documents for whichAhis permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning laws 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 Electrical 21 work until the completion of the same. .' Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and f re Officials are provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: "r< i " 1.Foundation or Footing Final: 2.Sheathing Inspection . 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final' 6.Insulation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do'not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT IME AppiicaiionNmaber....................................... .................. s //- - - Permit Fee......�[P.d..:...:......:.......Other Fee........................ MASL Total Fee Paid................. CA TOWN OF BARNSTABLE Pew Apra BUILDING PERMIT APPLICATION Section 1-Owner's Information and Project Location Proj ect Address �. �Z Wage )Iya m/5 Owners Name A vIA- r Owners Legal Address 1 City ��6 _l� �� �- State Zip Owners Cell#. E-mail Section 2—Use of Structure Use Grroup ❑ Commercial Structure over 35,000 Oubic feet ❑ Commercial Structure under 35,000 cubic feed - ❑ Single/Two Family Dwelling Section 3—Type of Permit - ❑ New Construction . ❑ Move/Relocate ❑ Accessory• Structure ❑ Change of vs rn ❑ Demo/(entire structure) ❑ • Finish Basement ❑ Family/Amnesty ❑ Fire Alamo Rebuild ❑ Deck Aparhnent Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar b"Lovadon ❑ Pool ❑ Insulation Other—Specify = Section 4-Work Description r T - T ast undated:219/201 S Application Number................................................. Section 5—Detail Cost of Proposed Construction_ f "1 V v Square Footage of Proj ; Age of Structure' ' "tau Dig Safe Number ✓V # Of Bedrooms Existing J� Total#Of Bedrooms(proposed) 1 TO MPH Wind Zone Compliance Method ❑ MA Checklist D WFCM Checklist Design } Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal t ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes El No Section 7-Flood Zone Flood Zone,Designation Within or adjacent to a wetland; coastal bank? Yes ❑ No ❑ Section, 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed ° Rear Yard Required Proposed R Side Yard: Req red Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No t r Last imdated:2/92018 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street - Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit:Buulders/Contractors/Electrician.s/PIumbers Applicant Information Please Print Legibly Name(3usiness/0rganizadmvindhiduai): - Address: 1,C9, Jl� City/State/Zip: tl, / 6C hone#: Are you an employer?Check the appropriate box: • . Type of project(required): 1.[dfam a e I er wrth �— 4. []I am a general contractor and I oY * have hired the soh-contractors 6. ❑New construction employees(full and/or part-time). 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• Fj 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.❑ I am a homeowner doing all work officers have exercised their 11.❑Plmnbing repairs or additions myself[No workers' comp. right of exemption per MGL 12.[]goof repairs ffis ce required.]t C.152,§1(4),and we have no 13.❑Other employees.[No workers' comp.insurance required.] *Airy applicant that cheoks box#1 mast also fill out the section below showing their workers'compensation policy information. _ 1 t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit, di - g such.� Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state vybether or not tbD36.eentities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. -a p I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy job site, c information ' Insurance Company Name: [2�1 (4444 Policy#or Self-ins.Lic.# L `� `.(VI Expiration Date: n Job Site Address: �y InAZ In �7 7(-- City/State/Zip: 1 Attach a copy of the workers'compensation policy declaration page(showing the policy num r 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 tine of up to$250.00 a day the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the for ce coverage verification. I do hereby certify n e airs and penalties of perjury that the information prov' ove is true and correct Si e: Date: Phone#: � �7 official use only. Do not write in this area,to be completed by city or town offccial City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Budding Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector. 6.Other Contact Person' Phone#: TOWN OF BARNSTABLE BARNSTAHM F BUILDING DEPARTMENTULM APPLICATION FOR CERTIFICATE OF OCCUPANCY Date Building permit application number map/par Address of structure Area of structure C.O.will be issued to Name of Tenant Edition of Building Code Use and Occupancy Classification Type of Construction Design Occupant Load Is the facility licensed by a State agency Yes ❑ No ❑ !f yes If yes, name of agency Relevant Code of MA Regulations(CMR)that apply Automatic Sprinkler System Sprinklers provided? Yes ❑ No •❑ Sprinklers required? . Yes © No ❑ Building Department Use only Special Conditions: ;Estimate, 1519 Date Feb 23,2018 Cape & Is .lands Construction Co. P.O. Po Box 210 Terms Centerville Ma. 02632 508.775.7663 Ship,Via Ship Date • Sarah&Ray Cericola 292 Main St. Hyannis, Ma.02601 508-776-0522 Re-MODEL RE-MODEL 54,900.00 Obtain town permits for commercial renovation. Stage sidewalk. Strip existing face of building. Perform necessary structural repairs. Reframe and Instal window bank per plan. Build new face for building using Azec composite materials. Quote based on estimated time and materials cost. Actual cost may vary with degree of damage found once face of building has been removed. Labor rate$75 per man hour. Materials at constructors cost plus 20% Disposal at cost ¢a: Permits at cost General liability and Comp insurance included r, -vim t This project may be completed in as little as 3 weeks but is being quoted at 4 weeks as an outside estimate. Labor allowance$48,000. co ct� Materials&equipment allowance$6,000. Disposal allowance$500. p-J rn Permits&time$400. Total $54,900.00 j i nature i i j 's Town of Barnstable Hyannis Main Street Waterfront Historic District Commission www.town.barnstable.ma.us/hyannismainstreet T:' ;' �'-T �l T t;-, B iV.,_i 1"iJJf.�L. i i.;l.0.•.Lr..'v\E i.. Decision—Certificate of Appropriateness 20 and W Certificate of Appropriateness - Sign age Sarah Cericola d/b/a The Studio by the Sea 292 Main St., Hyannis The Hyannis Main Street Waterfront Historic District Commission,pursuant to the Code of the Town of Barnstable Chapter 112,Historic Properties,Article III,Hyannis Main Street Waterfront Historic District,hereby approves a Certificate of Appropriateness for the following property: -- o Property Address: 292 Main Street,Hyannis Assessor's Map/Parcel: 327/255 0 a t At the February 7, 2018,hearing, after consideration of the testimony given and materials subnE(dd by the applicant- and members of the public, the Commission'found the.proposed design for the exterior renovation�s as outlined a proposed business signage will appropriately contribute to the historic character of the Hy, is Main Strelq Waterfront Historic District The Commission considered the material, design, color, location, y�d contek' of tl proposed renovations and found it to be appropriate for the protection and preservation of the distridt. Base&5 theZ findings,the Commission voted to grant the certificate of appropriateness subject to the following conditions: 1. Restoration/renovation of the fagade is approved in accordance with the application as submitted on January 19,2018,with the exception of Azek material being used instead of wood. 2. Restoration to include; removal of existing metal fagade and replace with Azek,dental molding. 3. Removal of awning entirely and replace with new wood sign in this area 170" x 12", with blue lettering. 4. Replace 3 upper level windows with 3 sash windows. 5. Paint will remain the same dove gray with white trim colors. Door and existing brick work will remain unchanged. 6. Applicant shall. obtain any necessary 'permits from the Building Division before commencement of any work/installation. �, Present and voting in the affirmative to grant the certificate of appropriateness were: Taryn Thoman,David Colombo, John Alden,Betsy Young and Timothy Ferreira Opposed:None Taryn Thoman,Vice Chair f Date Hyannis Main Street Waterfront Historic District Commission cc: Sarah Cericola,Applicant Building Commissioner File I,Ann Quirk,Clerk of the Town of Barnstable,Barnstable County,Massachusetts,hereby certify that twenty(20)�f y days have elapsed since the Hyannis Main Street Waterfront Historic District Commission filed this sect-lion and that. . no appeal of the decision has been filed in the office of the Town Clerk. �:�w Signed and sealed this-day of MI-TRC II under the pains and penalties of peJ 9 q`` Ann Quirk,Town Clerk Town of Barnstable Hyannis Main Street Waterfront Historic District Commission Application Certificate of Appropriateness Application is hereby made for the issuance of a Certificate of Appropriateness under M.G.L.Chapter 40C,The Historic Districts Act for proposed work as described below and on plans,drawings or photographs accompanying this application for. Assessor's Map No. 3��' Parcel Nosh' - Address of Proposed Work 02-(oU t Applicant-Name SA-QP { PN CEK( COCA Applicant Mailing Address 3�J Wk&-J t&D Town/State0p W 4KMOUTH MA- " -`3 Applicant Phone Number Applicant E-Mail _1 '(Z R'4- c&- Dt o 19�4 7h'E S�08 . com Property Owner Name Jr�Akq Cab CD LA Owner Mailing Address-,J 1 17 Town/StatelZip l-�1 MA -fo�-� y[ Owner Phone ) 3DI �))-9 Agent or Contractor Name COC tSl t S ut� �OM� Agent or Contractor Address Po tea D Town/StateMp C�rGOVI tL Pr C))L3) Agent or Contractor Phone L5 cA) aa5 t03 Agent or. Contractor E-Ma7 . c 1N PsTII�l7 l St,A-1� 5 co S1 C`il of c PROPOSED WORK = c� Please check all categories that apply: w e� Building Type: Commercial ❑ Residential ❑Accessory c Fl Other00 w Work Proposed: NJ 1. Building Construction: ❑ New Building ❑Addition Alteration 2. Exterior Alteration: $Z Windows_ ❑ Doors Siding ❑Roof [,Other nCADC 3. Exterior Painting: 4. Signs; New sign ❑ Alteration to existing sign 5. Accessory Improvement: ❑ Fence ❑ Parking Lot o P ❑ OutdoorDinmg ❑ Awning/Canopy 6. Other: Rt✓MoV A 1. A W 0 NSTABLE HYAi,! ` 1ATERFRONT Page 1 of 3 HISTC--t u J, ,m,C-i COMMISSION i Hyannis Main Street Waterfront Historic District Commission BUILDING MATERIAL SPECIFICATION SHEET Please complete this sheet only if new building construction or alterations to an existing building are proposed. Fill out all sections that are applicable to your project. Include materials;specifications,dimensions and/or colors,to be used. FOUNDATION SIDING TYPE COLOR CHIMNEY TYPE COLOR ROOF MATERIAL COLOR ROOF PITCH DOORS COLOR `= a KrCT t— S"fYZ C1 L"` 0 STlnllr� WINDOWS = COLOR_ k ; �E SHUTTERS COLOR 3-1 TRIM W CLOD COLOR N�k � -----a °D � rn GUTTERS PATIO/PORCH/DECK GARAGE DOORS COLOR AP i 'D OTHER TOWN OF E HYANNIS MAIN Sl HISTORIC DISTRICT G`O.,,:VdSZ— Page 2 of 3 Hyannis Main Street Waterfront Historic District Commission DETAILED DESCRIPTION OF PROPOSED WORK Provide detailed specifications of the proposal Include a detailed description of changes to existing conditions,if applicable. • Describe proposed materials to be used,desired colors,manufacturer's specifications,etc. • In the case of signs,give locations of existing signs and proposed locations of new signs. Attach an additional sheet,if necessary. (���(-�t►.l'�t� �3F1Ca�� n•I �1.��L1�taSCs I S 5���►� ��.�— VA mou ' e" 1 o s Ke ' --� u� C71 e. 12 C7 r r�l U t i t-) i Signed Applicant-Agent C" rn Date I �" APPROVED TOWN OF BARNSTABLE Page 3 of 3 HYANNIS MAIN ST WATERFRONT HISTORIC DISTRICT COMMISSION volt 01 All Z SEE s S3dsp"Y'4 41 fin �-' •5 b` m;�' a .° � - .><+' nab a 4 if I a p t•� , ff A f - E l,by � s , � TP �^ •g4 �Sri �� + ' �� x°xk. .�. yd�,�,,•`; .� '�'yxe + 4. ` �-�° �� �a•a�ra ' � � �����' � ate` � h "� � �� n� a.��, nix' � �'°p,p�!� s� ✓' ?s�` � ;uCF ���F� � ...����'"➢r `�6 �` ��� k�, -�'%� �� �: 4 ";�s �* • 3� .°.,f#+e -v7 �S ���Sam :.������t��� s Fr �'� .te � #�•nr��.. j � � � �.. � �.: �4 k; , n t ,k„ gid ,�F '"'I''��. �' ,v � ", Y' _ r a• x - fb - `'� i:i x�' �,� �i'' $ram �'' 164 too be VIA owl c a hill �' b Sri• $"'. ,n'. a• t�,t g w �, ' 2 ' �s, s"`� ,--yn• .h"` a r ,d N.-_. ^ems- '`,�,, b '''' , Gool 4 � M1 , ''fir ,f''. �Iri ,,��y� .mow, r( �W��' .R �} 4;. •F�� � C mR� .'�> JA a s _JB5e1 r IR ki 4 K•��9� 4 4 R:§ .] 1' "�A a rop �`wr ,# �,•� �'�� � rya A+'`+�, �'� � � �e� vo,"'� v�t 4Y.�K 6 R. w. �'�° -.J.� °� � ,:'' ma's n � � 'H� '„,3- .a, 4 •�""'y.Ks' '�i"' �.. +.� }•�•,N�:t e -,,,, .A,' s,3•� +�^ '. f ,� ax „ - • � ,�s r .a:."�'. . Y �' A��. r,� ''� � .Si.?.M........,.rT���[. .._._.. 1 _ '. _�. -_'=fir ,....-...cam••---.K. f- � - (i f�C'?(�jr5� f..'- "'T X �&'."�-"•*' 1 #..* t � w ar'4 T^ " ,,t y,f 2 4 .. ( f - !"' /!•. �-R �I i t l ,l�( ' .F/�t i I. •� .;r� � (� � •. d I # � t.."YYW� a3� (,. S1 AP� ...E [, sJll , Zy� ,�! � t +f' t� 1 .tf .s•, �� ll./S c� ¢ 5 - ..tt'..+.: .,«'J ��i P.na$ 1._ ,� *. ,.s., >„ ,_.•+1+e. �,.�•.., x. 1. ♦ wr e _ • • _ .- h TA'YC. ":..T�ltlS.�Y:Y Y•M.••�.YQ'h- ^SaK".�'.YWtl['.�' l iY.w. •1`•liC•r•'•f�.••.+Y/Q'Y:h'^T?WR..tA�"*' +"4"t E'.-lyY;- '^Y^Y.S�.� ? N!Zi �'!ZW" $,� r+ r , J, t aO i �9 1 ' kZ4 ' f It IF tea. (Z" Air r,t i3. 1 kv A m 7. in OW- xF t �� .�►-..a��� � � _ � � � . mot, -,.. ' r �.•(= . .,,,•' �Iw Ir:.rt„_ter - .r (�. "E1�4i�, �, �i,:�..»��s�,,�' .�� .. 4 "`�.e �� '�i�'�l`\ , , i / �(•:'' �:,,.'; �►f•�friirll�� � � � fit � �,f �1-�� a���� �� � ��-� ����"` �,; ✓�:. -, a/1 a,«+.. l.• .+r ,4 . .wa k � . '. 5 3' � ,.��� � -.. s.- top I'hc c5Ludio by Lhc 6 c ait - s J ._ * •� i oil T . ; '+ .,x.E" r,< . _. r f Town of Barnstable Hyannis Main Street Waterfront Historic District Commission Application Certificate of Appropriateness for Signage Application is hereby made for the issuance of a Certificate of Appropriateness under MGL,Chapter 40C,The Historic Districts Act,for proposed signage as described below and on drawings or photographs accompanying this application. CHECK ALL THAT APPLY: / 1. Business Sign 2. Open/Closed Sign 3. Trade Flag 4. Trade Figure or Symbol, 5. Location Hardship Sign Assessor's Map No. Parcel No. J�� ' w A Address of Proposed Work 91 MA 1 f j FRS -_G - � n Applicant �1 t oL G6g_c C-0 Tel# s()� �`� a-SSt rn k L� � Applicant Mailing Address Town/State/Zip_V- `I���M0�1-� Applicant E-Mail Address �A"t\ Property Owner 1 \ U -� �`2c� Tel# �� Owner Mailing Address �� ( � Town/State/Zip yv `I � is 1 Nl3 Agent or Contractor � � �; 1 SAS � S Tel# Mailing Address W3 Town/State/Zip Agent E-Mail Address V lJf'� S� �S CQYY1 Signature of Applicant Date ❑ For Location Hardship Signs&freest ing Trade Figures or Symbols to be located on private property: Check box if property owner has granted permission to locate Sign or Figure on their property abutting the building front. i Business Sign 1: Size of Sign v, x Material(s)of Sign 0" L AS` 0- Material of Lettering(if different) Will the sign be illuminated? Ye I`No If yes,what type of light fixture Location of Fixture Business Sign 2: Size of Sign x Material(s)of Sign t Material of Lettering(if different) Will the sign be illuminated? Yes/No If yes,what type of light fixture Location of Fixture Open/Closed Size of Open/Closed Sign x _= ZtE Sign: Material of Open/Closed Sign: ` N If Neon,indicate color(circle one option): Red 1 Red&Blue %o cn Color of Open/Closed Sign: c r U rn Trade Flag: Size of Trade Flag: x Material of Trade Flag: Trade Figure Dimension of Trade Figure or Symbol: x x Or Symbol: Material of Trade Figure or Symbol: Location Size of Hardship Sign: x Hardship Sign: APPROVED� Material of Hardship Sign: Lettering Color and Material: TOWN OF BAARNSTAK E HYANMS MAIN ST WATERFRONT HISTORIC DISTRICT COMMISSION Page 2 of 2 'Uw p(. Y 12 x 145 (12.08 s.f.) 14, ab. wn5 I s � _ as • y IiR__ t Iij� }y s < y i. V vj Tkiiii. J ;S -Studio by the Sep • ! �• (�'"' 3�'1, '-1 .� e� co r--:) _ a .� Wiz.. - '-"dc,.a. - __ - ...r—•- — DATE Monday, January22 20 NT- CONTACT: FILENAME APPROVED;BYj t U to ban MM l©�'i'iQ •-o w n n 103 ENTERPRISE RD, HYANNIS, MA 02601 � o o. `e mw •• �� 508-815—&431 COMMMIN ammarm MZMM ommmmm @@MEW NY'A ;.;lS ivtAiN ET' WATERFRONT HISTORIC DISTRICT COMMISSION ' ® DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE F5/14/2017 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 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 endorsement(s). PRODUCER FRANK L HORGAN INSURANCE AGENCY INC N,011NT CT 44 BARNSTABLE ROAD PHONE FAX PO BOX 250 (A/C-No Est: A/C No: HYANNIS, MA 02601 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURERA: LM Insurance Corporation 33600 INSURED INSURER B: CAPE & ISLANDS CONSTRUCTION COMPANY INC PO BOX 210 INSURERC: CENTERVILLE MA 02632 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 35624081 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 EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD MMIDO COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES a occurrence $ MED EXP(Any on p I$on) $ PERSONAL&ADVINJURY 5 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ �- POLICY JET El LOG PRODUCTS-COM-PP/�PAGG $ OTHER: COMBINED SINGLE AUTOMOBILE LIABILITY IMIT S Ea accident It ANY AUTO BODILY INJURY(Pelperson) $ OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S .. AUTOS ONLY AUTOS ONLY Per accident S � UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTION S 5 A WORKERS COMPENSATION WC5-31S-377540-017 5/7/2017 5/7/2018 ,/ I ERSTATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ 1 OOOOO OFFICER/MEMBEREXCWDED7 - �N N/A (Mandatory in NH) EL DISEASE-EA EMPLOYEE 5 .100000 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA. This certificate cancels and supersedes all previously Issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 MAIN ST ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA 02601 AUTHORIZED REPRESENTATIVE LM Insurance Corporation ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 35621081.1 1-377540 1 11-18 WC I n0210258 1 5./14/2017 11:09:46 PH (PDT) I Page 1 of 1 + Office of Consumer Affairs&Business Regulation i e HOME IMPROVEMENT CONTRACTOR Registration:! 65936"� Type:} . Expiratio, Private Corporation r CAPE&IS CQI C N9 C0 INC. r , JOSHUA-KOURI al L E.MA 02601 Undersecretary { License or registration valid for individul use only before the expiration date. If found return to: '. Office of Consumer Affairs and Business Regulation ' 10 Park Plaza-Suite 5170 Boston,NIA 02116 1 of ali without signature Massachusetts Department of Public Safety �= Board of Building Regulations and Standards License: CS-074660 Construction Supervisor JOSHUA X KOURI } PO BOX 210 , CENTERVILLE MA 02632 Commissioner Expiration: 02/12/2019 C Restricted to: onstruction Supervisor -- Unrestricted-Buildings of an use less than 35,000 cubic feet(991 cubiou enclosed s P which contain Space. meters)of i Failure to possess a current State Building Code is cause for 1revocationr of this license. DPS Licensingion Of the Massachusetts information visit: W.MASS.GOV/DPS Application Number........................................... Section 9-.Construction Supervisor Name a L Telephone Number 3 C9 (P Address 6n �D ,�j/p City - ,I(,•C State A�Zip �¢ License Number - 7'� 60 License Type Expiration Date (� � I �� Contractors Email_�__5� 4L�`5(CIS �Y�S C�farrCell# 6� C9 I understand my responsibilities under je tales and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State � Bu Code. the construction inspection procedures,specific inspections and docentation regnfred by 78 d the of Barnstable.Attach a copy of your license. Signatilre % Date41 Section 10—Home Improvement Contractor Name_ �� ,`�C I,E) - Telephone Number — —7 — Addressl,/, City State zip Registration Number Expiration Date 1. ' l(\-7 I understand my responslwuMe rates and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts S Code. I understand the construction inspection procedures,specific inspections and documentation,re 8 f d the Town of Barnstable.Attach a copy of your EUC... Signature Date Section 11—Home Owners License Exemption Home Owners 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 f docamentaiion regained by 780 CMR and the Town of Barnstable. o Sigoattae Date LICANT SIGNATURE Signature Date Print Name b� �� i Telephone Number � � ��� E-mail permit to: ac,4 c9 Section 12—Department Sign-Offs Health Department © Zoning Board(if requirecn Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13—Owner's Authorization L as Owner of the-subject property hereby authorize to act on my beha4 in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner daze Print Name ,I Last undated:2J92018 {. TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 327 255 GEOBASE ID 24368 ADDRESS r�� M_A IN STREET (11YANN I S PHONE �'1�hiyanrds ZIP - LOT 42LC9 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY i S PERMIT 24220 . DESCRIPTION GALLERY 292 (18" X 48" ) PERMIT TYPE BSIGN TITLE SIGN PERMIT '. CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 BOND $.00 Oki CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE * BAMSTABM • MA83. OWNER CLARKE, WILLIAM T & GLO r 1639. A� ADDRESS 24 PAINE ROAD ED MI`►I SO YARMOUTH MA BUILDING DIVISI.ON? BY DATE ISSUED 07/03/1997 EXPIRATION DATE "` The Town of Barnstable �a ° Department of Health, Safety and Environmental Services Building Division fp�N,t 367 Main Street,Hyannis MA 02601 J'I Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Application for Sign Permit Applicant: U,/�- � CC� z-K Assessors No. 3.;?'7 Doing Business As: C- L.( � 2q 2 Telephone No. 7 75 — 2 SSZ Sign Location V�to"-,t t'1 Yy(A , ozko 1 StreeVRoad: Zoning District:��N l� Old Dings H : Highway? Yes 'o" Property Owner Name: W I LC(A4v` Telephone: -775-—ZSSZ Address: Td• & Village: 0-Ww-AW 1 D, YoA- 0z�31 Sign Contractor Name: - AX� OQ LAW LQ--- Telephone: Address• l05- C!F{'2-(`MWAS WM Village: W� PAk&5'ft VWA•0ZGk8 A Description Please draw a diagram of lot showing location of buildings and emsting signs with dimensions, location and size of the new sign. ?his should be drawn on the reverse side of this application. Is the sign to be electrified? YeIS (Note.If frs, a ivuingpermit is required) I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of7Bamsle Zoning Ordinance. Signature of Owner/Authorized Agent Date: 6k q Size. l /# X Permit Fee: Sign Permit was approved: xzoa Disapproved: Signature of Building Official: Date: _ —� a GALLERY 292 CONTEMPORARY ART TO: Ralph Crossen Building Commissioner FROM: Carl Lopes ' DATE: 7-3-97 RE: Sign Permit Application Attached please find the application for a sign permit for Gallery 292 at the William Clarke Photography Studio. The above logo design is an example of the sign. TYPE OF PROPOSED SIGN: vinyl lettering attached to inside of window DIMENSIONS OF PROPOSED SIGN: 18"h x 48"w COLOR: white only MATERIALS: self-adhesive vinyl BRACKETS: none Affixed is a photograph marking the window location of said sign. . T m a --, 292 MIA I. N STREET HYANNIS , MA 02601 508 775 2552 Town of Barnstable ° Regulatory Services MAW.Wss.snnxs' a' Thomas F.Geiler,Director ►,�.�'`�ft Building Division O Tom Perry,Building Commissioner 0O VI IOtd 200 Main Street,Hyannis,MA 02601 Office:'508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL OF LICENSED CONSTRUCTION SUPERVISOR FROM PROJECT Construction.SupervisorLicense # ,hereby certify that I am no longer the Construction Supervisor listed on the application for the project under construction as authorized by by building permit c#-�66 0.01'� ,issued to (property address) e 11 /y on �`16 , 20?. . I also certify that on 200 R',I notified the property owner, that the project under construction must cease until a successor licensed Construction.Supervisor, is submitted on the records of the Building Division. IV LICENSrrER D E q/forms/newcontr reference R-5 780 CMR 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map 3 .� Parcel dR5 Application# Health Division Date Issued Conservati Division Application Fee Tax Colle r �pon (2ot b_et)-(— Permit Fee Treas Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address o"�Z /-yI G AJ S 7— Village /f CIIAVAI l S ,0, 4,r Owner z&Y'/�/yA C�kez e coc_/4 Address Telephone Permit Request /Pp tit> �d d/4-/Z ei �- -- 0 S ; 8 mC as Square feet: 1 st floor:existing �+(ooPlain 2nd floor:existing proposed m Totahnew d,. Zoning District Groundwater Overlay C? m _ w � Project Va&n Construction Type _ r� Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑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: existing new Total Room Count(not including baths):existing new First Floor Room Count x 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 BUILDER INFORMATION Name. '/ Telephone Number63 6 AS Address )C License# All pok / ZVA.6�-{7 Home Improvement Contractor# /' S ',2 l 0 Worker's Compensation# ?-Z Z- le" ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 06/- /S 7-1�_6 SIGNATURE r DATE P/ k �k FOR OFFICIAL USE ONLY %,APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER s. } DATE OF INSPECTION: ` FOUNDATION FRAME INSULATION FIREPLACE y ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL f GAS: ROUGH FINAL 'i FINAL BUILDING t` DATE CLOSED OUT r ASSOCIATION PLAN NO. i. I ., The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): / 75,14 , S(6t,Q//a-�- Address: City/State/Zip:_/�,�'s��til�S /�®e�%O% F,SiPlone.#: �� �j '57 s ! Are you an employer?Check the appropriate box: Type of project(required): 1.U i am a employer with 4. ❑ I am a general contractor and I employees(full and/or art-tim * 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 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LEI Plumbing 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 pomp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the 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: / Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: 4 yo2 zl71241&1 S .- City/State/Zip: j�Y,9y1/ � �/�-4,�6(7 / 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 ce r un er the narns and enalti s o perjury that the information provided above'is true and correct sinafore: c Date: Cf. eo Phone#: Ct3�"' ^ r! 4 Official use only. Do not write in this area,tb be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions ' r Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of cornphance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,letely,by checking the boxes that apply to your situation.and, if P necessary,supply sub-contiactor(s)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit(license number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"I.he applicant should write"all locations in . _(city or 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 year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street v Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia 1 y � . 5, yrj, +Er�,ti Town of Barnstable Regulatory Services EAMSTy iassAB1�$ Thomas F.Geiler,Director 039.��FDMA'IA`� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder Ctr-k60Ili , as Owner of the subject property hereby authorize �2d�'`�Y , �--�ie � to act on my behalf, in all matters relative to work authorized by this building permit application for: + -� t (Address of Job) Signature of Owner Date w .f Print Nam If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:F0RMS:0 WNERPERMISSION .r r SHE Town of Barnstable OF Tp� ' Regulatory Services saRvsTns . : Thomas F.Geiler,Director 9q, b`9 .`0g Building Division prFD �rA Tom Perry, g Building Commissioner 200 Main Street, Hyannis,MA 02601 , ww.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occtipied-dwellings of six lunits orrless 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 faun 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 1'09.1:1) The undersigned"honieovmer"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 Departme4t\ minimum inspection procedures and requirements and that he/she will comply with said procedures4and requirements. c 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 01-16-08 11:51am From-AIG +973 331 8599 T-657 P.001/002 F-371 4. RI ''NC C:ER� ':fF .CAT PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION O G CERTIFICATE ONLY AND CONFERS N RIGHTS UPON THE T Goldman&Associates Ins Financial Sery HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 933 Falmouth Rd, Rt 28 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Hyannis,MA 02601 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE.INSURANCE COMPANY INSURED Timothy Storer PO Box 845 Hyannis,MA 02601 COVERAGES.:cp.:.i;. ',I•t,;.;.I - i,,. ;:; ',:,:''.' �,�;'rl"'�,:'1' 'i.('.a r .:�_; . _ r.' i'_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING 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 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. Co LTR TYPE OF INSURANCR POLICY NUMBER POLICY EFFECTIVR DATE POLICY EXPIRATION DATE A WORKERS COMPENSATION _ AND EMPLOYERS'LLABILITY LIMITS ME PROPRIETOR! PARTNERSlEXECUTIVE OFFICERS ARE: wcL'' XCL❑ 1 8264184 _ 1/08/2008 1/08/2009 STATUTORY LIMITS . :'.i•" OTHS Covereoe Applies to MA Opormlons Only, EACH ACCIDENT $ 100,000 DISEASE POLICY LIMIT $ 500,000 DISEASE-EACH FMFLOYEE $ 100,000 DESCRIPTION OF OPERATIONSNEHICLES/SPECIAL ITEMS _ RE:TIMOTHY STORER IS COVERED BY THE WORKERS COMPENSATION POLICY. ra CERTIFICATE HOLDER CANCELLATION z— TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES QE CANCELLED BEFORE THE 200 MAIN ST EXPIRATION PATE THEREOF,YHE I6SUING COMPANY WILL ENDEAVOR TO MAIL Ig '"` CIO HYANNIS, MA 02601 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,OUT ` _ FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY OF :. ZIP ANY KIND UPON THE COMPANY.ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Tv ...I M t 4 f I , oFtMME r Town of Barnstable 9sntuvsTABLE A Regulatory Services 1639. 0 a `7 i63� .0 Thomas F.Geller,Director RFD MA'S A Building Division Peter F.DiMatteo Building Commissioner 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Date: Name: Address:- -0222- PA//\J 87 Village: /ttn/nl>S r: Zoning: Current/Last Use A�26)Cl�-Ic S71&0 Proposed change of use lme Change of Use Request I, hereby voluntarily surrender the use and knowingly give up all rights associated with its history. At this time I request that a Change of Use permit be issued for the aforementioned use. Gtc gnature Approved Not required Staff notes: Q:Bldg\forms\changeuse f- 6 TO: Ralph Crossen Building Commissioner FROM: Carl Lopes Clarke Photography Studios 292 Main St. Hyannis,MA 02601 DATE: 7-3-97 RE: Gallery 292 Attached please find the floor plans you requested regarding the implementation of Gallery 292 with the William Clarke Photography Studios at 292 Main St.,Hyannis. We have decided to place Gallery 292 on the first floor and leave the photography studio in its current location. This will require no change in the facility structure or plans. Artwork will be displayed on the first floor where photographs are usually hung. The offices will also remain on the first floor. Therefore,the second floor will continue to be utilized as a supply storage area. No restructuring is planned for the second floor. Please advise me if any permits are required to include Gallery 292 into the existing first floor space. Thank you. 0 0 i �8 N , o S7ak'FIG� IP TZ_oovr- a _ COEx" T 1 1 1 ------- �1 i I<M VV , I F-y-CIE-S--CIF—/y I 38 7777 ��olo �b13B Gfo v�oN A o LLB ! /g v �� s �- T I�Y� air N - t � r 'ot S h LZ ZRZ �MAc�N S'C, t+ A—t-JNlS ouk- I �Awt IvG- BY T ��_I,oRES �, -- IJ (� � � � �� � � � J �� � _�. � J � � �� f.. . ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 63c Map Parcel � li ion # Health Division Date Issued G'Z � - pr Conservation Division Application Fee Planning Dept. Permit Fee A97 J n(1 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address S Village Owner Address a-�8 " 'r✓ �7, vd0 Sw t c Telephone :� j q Permit Request V' v Square feet: 1st floor: existing proposed 2nd floor: existing proposed"m Totem new_ .Zoning District Flood Plain Groundwater Overlay b+.3 iJ 'e1r •� Project Valuation 1 t 100,6bd Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) l Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's1Highway�❑YfA ❑ 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: 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 ❑Ye''s ❑ No If yes, site plan review# Current Use Cl Proposed Use Cti� APPLICANT INFORMATION (BUILDER OR HOMEOWNER) l Name C-- Y� Telephone Number �3 7 Addr License # 65 to " Q f.A't,N g ,.,•" �/ Home Improvement Contractor# 3 Email Worker's Compensation # UJ6_9 0-X- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO P SIGNATURE DATE I l FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED = MAP/PARCEL NO. - ADDRESS VILLAGE r OWNER DATE OF INSPECTION: FOUNDATION FRAME !' INSULATION € FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DAT&CLOSED OUT AS§4GIION PLAN NO. the Commonwealth of Massachusetts Department of Industrial Accidews �. Office of Investigations 600 Washington Street Boston,MA 02111 nww,mas&gav1dia Workers'.Compensation Insurance Affidavit Builders/Contractors/E ect6cians;Plumbers Apphcant Information Please Print Lezib Name. an;�et na�lFnt�dpa�-: (v � Y— ���1'✓L0 ./"`°l-- Address: 2.0 (^-iD p,-t�i— City/stated g 0,44 l Phone#:.5 GAP 7 95 Z �-- Are you an employer?Cheri€the appropriate bov T of project r 4. I am a contractor and I Type P I (required): 1-9 I am a employer with t ❑ � 6. ❑New construction employees(full andforpart-time).* have hired the sub-contractors 2.❑ I am sole proprietor or partner- listed on the attached sheet. 7- ❑Remodeling ship and have no employees. These sub-contractors ha-%T g- ❑Demolition working for me:in any capacity. e mp to 7�and have workers' 9. ❑Building addition. [No workers'comp.insurance camp insurance.Y y required.] 5. ❑ We are a corporation and its M❑Electrical repairs or additions 3.❑ I am a homeowner doing all.work officers have exercised their 11.❑Plumbing repairs or additions right of exemption per lv1GL myself �o workers't - c. 152, §1(4�and we have no 12.El Roof repair insurance required.] , 13.0 Other employees.[No workers' comp.insurance required_]' *Any WUc=dat checks boa#1 masx also fill out the section below showing their wodets'canrpensation policy infnrmatian. I Homwwners who submit this of idmv m&;catmZ they are doing all woA and then hue outside ca wactors mast submit anew affid2mit indicating sash ICon=tors that check this bar Est attached an additional sheet shouting the name of the sub-camtracton and:state whether or not those entities bane emphryees. If the sub- aatu wtoas have employees,diet'mast:provide heir warken'comp.policy number_ I am an emplqyer that is pmIding workers'compensation insurance for my eutpioyees. Below is the policy and jolt site information Insurance Company Name: Policy#or'Self-ins.Lic.#: C >90—�-G .00 0 0 /,:;;A—0 Expiration Date: '� Job Site Address: 99 l�`^t�r N City/Stawzip: 4t •t/•S r=;�'/ci Attach a copy of the workers'compensation policy declaration page.(showing the policy uurn er 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 imprisonmenk 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 Ndolator. Be advised that a copy of this statement maybe fon;wded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby carti.6,Heider tit pains acid penalties ofperjuty that the information protzded abme is true and correct Si 4✓� Date: l F l Phone M oso ci uuse only. Do not write in this area,to be completed by city or town offiiciaL City or Town: PermitfLuense# Issuing Authority(circle one): 1.Board of Health 2.ceding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 •1 DATE(MM/DD/YYYY) i 1v CERTIFICATE OF LIABILITY INSURANCE 5/21/2014 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). PRODUCER CONTACT Leonard Insurance Agency Inc NAME: Berkley Assigned Risk Services 683 Main St B _ NC.."N.Ext: (800)634-4589 /c.No.): 866 215-8118 Osterville, MA 02655 ADoResS: PolicyServices@berkleyrisk.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: Acadia Insurance Co. 31325 INSURED Carlos Flgueiroa INSURER B: - INSURER C: dba: C N F Remodeling INSURER D: 20 Captain Noyes Rd INSURER E: South Yarmouth, MA 02664 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 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 POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE - $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES Ea or ❑ CLAIMS-MADE ❑ OCCUR ❑ ❑ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMP/OP AGG $ POLICY ❑JECOT ❑ LOC $ AUTOMOBILE LIABILITY -❑ ❑ COMBINED SIFTLE LIMIT $ Ea accident ANY AUTO BODILY INJURY Per person) $ ALL OWNED ❑SCHEDULED AUTOS - AUTOS _- - BODILY INJURY Per accident $ HIRED AUTOS ROPERTY DAMAGE ❑NON-OWNED P AUTOS Per accident $ ❑ $ UMBRELLA LIAB ❑OCCUR ❑ ❑ EACH OCCURRENCE $ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $ DED ❑ RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ❑ ER ANY PROPRIETOR/PARTNER/EXECUTIVE O E.L EACH ACCIDENT $ 500,000 A. OFFICE/MEMBER EXCLUDED? N/A ❑ WC'ZO-ZO-000092-07 05/01/2014 05/01/2015 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500.000 If yes,describe under _ DESCRIPTION OF.OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 ❑ ❑ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) _ Election Category Election Status Name All Entities/Insureds: Sole Proprietor Include Carlos Figueiroa Figueiroa CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Thomas Tannariello THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 344-346 Commercial St. ACCORDANCE WITH THE POLICY PROVISIONS. Provincetown, MA 02657-2333 AUTHORIZED REPRESENTATIVE Signature: y- a ACORD 25(2010/05) BRAC 3139 HARNSrABM MAS S ¢ ,a� Town of Barnstable Regulatory Services Richard Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,"MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must. Complete and Sign This Section If Using A Builder as Owner of the subject property 0 hereby authorize &Y)l Cc !!��- to.act on my behalf, in all matters relative to work authorized by this building permit application for: . (Address of Job) �r QIr Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the-Homeowners License Exemption Form on the reverse side. QAWPMESTORMS\building permit fonnslsmokecarbondetectors.doc. Revised 050412 Town of Barnstable Regulatory Services �t Richard V.Scali, Director Building ]Division { sMtxsrnsM Tom_ Perry,Building Commissioner 1659. ,d� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION . Please Print DATE: JOB LOCATION: number street village `.HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occppied 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 largenwill be required to comply with the State Building Code Section 127.0~Construction Control. HOMEOWNEWS 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 persou(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. 9 Massachusetts -Departrpent of Public Safety Board of Building Regulations an d Standards Construction Supervisor ,_ License: CS-104107 ;; CARLOS H FIGUFYROA-- 20 CAPTAIN NOVES RD SOUTH YARMO�JTIhMA�0264 Expiration Commissioner 08/25/2015 l TAZIWAU C44QUM 3I u 9 L — Mosw a a Lsw J w _ m 1 > i 9 4 v o .�J D&W A2" �! CREDIT MEMO 00376330-001 Hyannis Invoice Date: 08/21/12 Shepley Account: FIGCAR 0145 216 Thornton Drive Hyannis, MA 02601- USA Branch: HYA Phone: (508)-862-6200 Phone: (508)-237-9592 IIJ I I II I III I I I III I I Illill 111 III I II III II I IIII III Fax: Delivery: 00376330-001 BILL TO: Reprinted: 08/27/12 07:34:03 SHIP TO: Carlos Figueiroa Fortes Way 20 Capt Noyes Rd 34 Fortes Way S Yarmouth MA 02664 Osterville MA Page 1 of 1 ORDER DATE: 08/21/12 SALES HYN Counter ORDER TYPE: WH SHIP VIA: Credit RTN FRT TERM: SHIP DATE: 08/21/12AGENTS F Cappucci ORDERED BY: FCappucci Trim Rhodes ENTERED BY: Dmiller ORIG SO: 374248-001 INV REF: 00374248-001 .::.:.. .. .: . ...... . ETD. ...............................::...................................................................................................................................................................................................................................:....::::....:............................................. -6 -6 BDL LRCW30BIRARMX -6.00/BDL 32.33/BDL -193.98 BIRCHWOOD 30-YR MX CertainTeed LANDMARK Metric 30-YR AR XX Orig Inv#: 00374248-001 Roof Shingles ; 3 Bundles Per Square " DO NOT MIX " SHAKOPEE MATERIAL PART# 6125 Reason: 100 - Overstock ****** SUB-TOTAL ****** -193.98 MA 6.25% -12.12 Cash Discount 9.70 Balance $-196.40