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HomeMy WebLinkAbout0408 MAIN STREET (HYANNIS) (9) i _ Town of Barnstable Building -wl Post ThisECard So:That rtJi ,, Bible Fol rom"the Street Approved.Plans Must be Retained on J,ob and this Card Must be Kept, + rAIUMA(3d.E. • s`as ` �':_;' '$,`, %aa -=` "eka ., '° `�::' £�,.G ar "e" 1. ':. li-5 '+'t ;e>sT , , xz ,: ' •ste Uil final Inspection Has Been Made r � µ �, �� a ' Where'a"Certificate of O,ccu anc s Re u�red�such-Buldm shall;Not�be Occupied uti1 a F,,mat.Inspection•has,been made Permit _ .r„-sa.:.;,:.">',�.<.< i,.:, h>'�'' .c.,: Pam..Y... Q,...>; ... ..z<,>�• .3€-v<.a= .g' M. <.._. x.�B�.F,,�A. .. �%«:s:<:R a.' ".*. ,.0. ,.T. ..�'Y.3'.,'°" .. _`t�< ... _<: ,..>x<... ` I=' Permit No. B-19-1075 Applicant Name: Jon Dean DBA Dean construction Approvals Date Issued: 04/03/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/03/2019 Foundation: Location: 408 MAIN STREET(HYANNIS),HYANNIS Map/Lot: 327 262 Zoning District: HVB Sheathing: t v r Owner on Record: FOUR HUNDRED MAIN REALTY LLC Contractor3-Name:"; JON DEAN Framing: 1 Address: PO BOX 2652 �` � Contractor License; CS;-095269 2 HYANNIS, MA 02601 - Est Project Cost: $38,000.00 Chimney: Description: ROOFING Permit F, ee: $ 160.00 Insulation: Project Review Req: Fee Paid-, $ 160.00 g < Date 4/3/2019 Final: kll'� e ` Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work au'thorized by this permit is commenced within six rrionths after=issuance. All work authorized by this permit shall conform to the approved appl cation and the approved construction documents'for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws;and codes. b Final Gas: This permit shall be displayed in a location clearly visible from access street or roa�°d`and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. >. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by'thi""AAdmg and,F re Officals are pravided on this ermit. Minimum of Five Call Inspections Required for All Construction Work:'; Service: 1.foundation or Footing Rough: 2.Sheathing Inspection (?, , vA, .. Z,, 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons cting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). c� fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT e Application number...... ....... t CI t, Fee......................1...................................................... U&NOST ' MAM ' " ' Building Inspectors Initial......... .................... .ems M!a Date Issued................y.. ..........?......................... 32--.�. (,, 2 Map/Parcel..... ...:�...�.�:1.....:........... . TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO W S/DOORS/TENTS/STOVES/WEATI-IERIZATION PROPERTY INFORMATION Address of Project: NUMBER STREET AMLAGE Owner's Name: Phone Number 5d 6 — $ 17— ?o g8 Sd8- 7.7 _ z4 6-'o Email Address: Cell Phone Number Project cost$ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above propertyI hereby authorize to make application ui g pe In acc a with 780 CMR o Owner Signature: — Date: TYPE OF WORK ❑ Siding ❑ Windows (no header change)# © Insulation/Weatherization ❑ Doors (no header change)# Commercial Doors require an inspector's review 0 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to C h ( J S y� Go Nfp r N�2 CONTRACTOR'S INFORMATION Contractor's name_XL VJ JG Q�lvtj Home Improvement Contractors Registration(if applicable)# / 3 (attach copy) Construction Supervisor's License# �-S S L( (attach.copy) Email of Contractor 9e&iy W AI S f C U e)>6'N Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY.IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. C � APPLICATION NUMBER s � *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No , if yes, a gas permit is required. Natural Gas Yes 'No , if yes,a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type . Testing Lab Offsets from combustibles: front back left side right side ' HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules,and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents - Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ^', Please Print rLe ' I Name(Business/Organization/Individual): -/T� 2✓ � / 4f Address: A5 , ' / ,1 ✓ ,� City/State/Zip: Phone#: Are you an employer?Check t e appropriate box: Type of project(required): 1.�arn a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors- 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8.- ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ P 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.[ 000f repairs insurance required.]t c. 152,§1(4),and we have no 13.❑ Other employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. �/� Insurance Company Name: A • ! { �Ik rA Policy#or Self-ins.Lic,#: I U 13 P 11L I AO Expiration Date: Z—/3 - ay Job Site Address: 7- (7� J+ 1 City/State/Zip: &A-/+ y i r MA (9 2&d Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is trije and correct Signature: Date: Phone#: Official use only. Do not write in this area,to.be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions 4 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 compliance with the insurance 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 to your situation and,if necessary,supply sub-contractors)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 cant'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' r 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 permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the 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 Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www,mass.gov/dia i Shea, Sally From: Jon Dean <deanconstruction40@yahoo.com> Sent: Wednesday, April 03, 2019 10:58 AM To: Shea,Sally Subject: we AC& CERTIFICATE OF LIABILITY INSURANCE 11�r1s9W9 ►Yf > ts THM CERTIFICATE 1$ISSUED AS A MATTER OF INFORMATION ONLY AND COliFE"NO RIGHT11:00H THE CERTIMATE NOi.OM TMS CEFC(MATE DOES t1OT AFRRMATIVELY OR NEGATIVELY AVM E D OR ALTER THE CO RA46 A"O=W D'Y THE POUC1ES a t,OW. THS CEITOW-ATE Of ON SURMCE GOES NOT C404"TUM A CONTRACT r13ET441EEN THE MWOW MSUAER(S)l AUTHORAM REPREWNTATMEOR PRODUCER.ANDTHECERTIFICATEEi91LMR R4PORTANT; It Attie""Rats halaet t$wk ADf MCNAL INSURED,tbw pokT 4 MWO=MOMONAL iNSURED pmviskws or be onoomo , If SUMG TION 19 WAIVED,AMeat to tha tum and eaMidaas of 1Eae pacy,,WnAin WOOS IAA MOWN an eead taut; A wrIgM on INGMIbeOedmftAM+xeYerrl er"16 CetttRaelehaMW161buofeucRa�rcelareeirren ,: Ptf-ham: F'AYCHEX INSURANCE AGE MY,INC,- owns �m.1a+x R sa�r 1 W SA9trtTM91 MVE - ROCHESTER„NY 146M 045 L MA Oft". CTIARAGH rE"FISM#E94 Ra: RE!liEil i *. THM 0 TO a99MY 71,W1 TFig�PO4MS OF 04=W4Q9 i1W W BEMY 44 W$k-1Ta OW19P TO Tt .1)4WF4D K&UM AEGkva<Fqt T@�POLICY FERICO r CAT N3ma-varAOMING ANY 1L'QWftVkNE.ftAd1A1 OR OWOMON of AM Ca w11ACT OA 01WR t r"ngsmcr t0 wKCH Dos GEIKTVEATE MAY W ISSUM CR MAY PE TNK n► :11 kMAWE AFfORDW B TFer-a'OUC9ES MbMISM-HE➢WN IS SMECT ro ALL THE:T EXCLU&CMSAW iSCfrDmoweS06u4cXROMIMtklafFaS1O+FNUAY"AVE EtE04RMU 6Y AkO MIA mum WAA&VAM. Comm ' Y".Htit9f2 EtT P1MX 5 91iIr1' •sa LAFF .'''i L1,A41r7?Cff .. ..�,,: ON AUTO t 1 t1i 1 A?x111�C19 area v ffinxn ra, 1 1 s:,;,ataswur Tc�exmx 6: 4 suzaaaxen �+c �1n1a FEMME walezanc�mm.,00a e R9� 7 . r-raamzsas� v ear• 9fJi48 49 =0ON I"'StYf;tSt4at cxs9CaeikfGaibs sloi.r 5.a,>.LGcrT"4 womn,"raw vn; ma ttuan fie[sbe s�aYE.�cdau emm■ tale iaa THE CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED IN REGARDSTOTHE GENERAL LIAI 1'Lm POLICY.,WIAIVER O SUSROOATODN 8RANTE©.IN FAVOR OF THE CERTIFICATE HOLDER IN RE+GARDS:TO THE.GENERAL LIABILITY AND WORKERS COMPENSATION POLICIES Prlrn 'and Nor-Cwi1rIbuwy is not available in MAW Guard I rance.. ceRTEm TE MxBM' £�kfECE TION GRAHAM LLC SUQUWAWOFTWMO 194 MOPWMSaE1CAWJr a 358"EST MAIN STREET' 1SATa MISWQV� .INXL:bE a O ACCIYRAAN�E 1igTi1{7 FiA,1CY IRGDU9�p11E: HYANN!S, tVIA 02001 " r >gii�l�aF6Arti[ttNi' 011811•21116AC COWMAMOW AJd&4reaar du ACORD H 12916M) The ACORD 1ka r e and k4a aaae registered ftw*a of ACCORD i Commonwealth of Massachusetts censure Division of PRegulations'gsionaland Standards , Board ofBuilding���l��� rvisor Consrd2jj 7 kr F, lres: 06/26/2020 CS-095269 3Wi � JON DEAN 102 LOWER COUN7Y�RQD; C DENNISPORT�11 02639 �` `VpISS3_(O - Commissioner y. s r Mass. Corporations, external master page Page 1 of 2 3 tic'-eo®-,s1> 'yr\r i.x Sqw s Corporations Division Business Entity Summary ID Number: 001030071 lllequestcertificate New search Summary for: FOUR HUNDRED MAIN REALTY, LLC The exact name of the Domestic Limited Liability Company (LLC): FOUR HUNDRED MAIN REALTY, LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 001030071 Date of Organization in Massachusetts: 06-09-2010 Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): Address: 408 MAIN ST. City or town, State, Zip code, HYANNIS, MA 02601 USA Country: The name and address of the Resident Agent: Name: RICHARD A. PENN Address: 408 MAIN ST. City or town, State, Zip code, HYANNIS, MA 02601 USA Country: The name and business address of each Manager: Title Individual name Address MANAGER RICHARD A. PENN 408 MAIN ST. HYANNIS, MA 02601 USA In addition to the manager(s), the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title Individual name Address SOC SIGNATORY RICHARD A. PENN 408 MAIN ST. HYANNIS, MA 02601 USA The name and business address of the person(s) authorized to execute, acknowledge, deliver, and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=001030071&S... 4/3/2019 f Mass. Corporations, external master page Page 2 of 2 I REAL PROPERTY (RICHARD A. PENN 1408 MAIN ST. HYANNIS, MA 02601 USA I ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual Report Annual Report - Professional Articles of Entity Conversion Certificate of Amendment w' View filings Comments or notes associated with this business entity: ' _..................................._ New search http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=001030071&S... 4/3/2019 Sent from Yahoo Mail on Android CAUTION:This email originated from outside of the Town of Barnstable! Do.not click links; open attachments or reply, unless you recognize the sender's email address and know the content is safe!' 2 Town of Barnstable RcE�PT 8AMASS 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit PP g Application No: TB-19-1069 Date Recieved: 4/2/2019 ^fir Job Location: 692 SCUDDER AVENUE,HYANNIS f/J Permit For: Building-Insulation-Residential Contractor's Name: HENRY E CASSIDY State Lic. No: CS-100988 Address: WEST YARMOUTH, MA 02673 Applicant Phone: (508) 775-1214 (Home)Owner's Name: MARILYN M GILBERT TRUST,ESTATE Phone: (508)737-7418 OF (Home)Owner's Address: 115 ACUSHNET ROAD, MATTAPOISETT, MA 02739 .M a Work Description: Insulation/Weatherization ra Total Value Of Work To Be Performed: $2,800.00 p Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Henry Cassidy 4/2/2019 (508)775-1214 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $2,800.00 Date Paid Amount Paid Cheek#or CC# Pay Type Total Permit Fee: $85.00 4/2/2019 ( $35.00 1 XXXX-XXXX XXXX Credit Card 2286 Total Permit Fee Paid: $85.00 4/2/ 0019 $50.00 1 XXXX-XXXX-XXXX- Credit Card 2286 �' ✓�'S�s�."z -�4.i �i#a� � � �'',.a�.T�� ° -�a�-"-'r� w� '�a ma`s' x am w.e..n"£,.,ana.*a,.d ,A£,a, .ryss a�w sz.,<• .,,� ,v�2�,3t. �a `d�u,: <'��,.. . z• .,3a '.•,. Mckechnie, Robert From: Russell Hamlyn <morganremodelingbuilding@yahoo.com> Sent: Wednesday, April 03, 2019 11:28 AM To: Mckechnie, Robert Subject: 45 north st. To whom it may concern, Jonathan Dean is an employee as project manager at Morgan Remodeling and building/DBA Russell Hamlyn. Thank you for your time, if you need anything else please do not hesitate to call at 781 576 0167. Russ Hamlyn Sent from Yahoo Mail on Android CAUTIOWThis ernail originated from outside of the Town of Barnstable! bo not click links, open attachments,or reply, unless you recognize the sender's email address and know the content is safe!' i