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Home My WebLink About0035 MITCHELL'S WAY �,/�i-/che/lsI GUPry . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map _ Parcels Application # Health Division Date Issued Conservation Divisions _ Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ; Historic - OKH — Preservation/ Hyannis Project Street Aid-dress A3S Vht Village -I�i.►IYI L� '' 1�,� `� Owner T�(� Address ' � Lt V1 S t M k4n Telephone Permit Request S .�c.rS S�r�-e�T 3M t+ & Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain - Groundwater Overlay Project Valuation(IZ Construction Type L.[ Lot Size p- Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes XNo On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout Other IA MAO 141kw fLq(- w-6-S to", 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 RBdm Court2 o 1 Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ OtherU�� 9 E p Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal sto ❑d'es ❑ 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 R,,4 ckLM, TO L Telephone Number Address _ ct ak LU QSkrY, a License # c5 SC),, bk nn i S MA DVJJ 6 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO n SIGNATURE C DATE - ,t '}` r FOR OFFICIAL USE ONLY 'APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER t DATE OF INSPECTION: h , t FOUNDATION FRAME f INSULATION FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH -- FINAL GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 4�' r The Commonwealth of Massachusetts Department of Industrial Accidents y1 �� Office of Investigations 600 Washington Street Boston, MA 02111 c ww g w.mass ov/dia ` Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le,-ibly Name (Business/Organization/Individual): J< �'�Cut Address: 16a 9!4P4 WeC,�eet"o � J e0N - S �� L64D City/State/Zip: SB bgA)V�l 07,W- d Phone #: A.ryou an employer?Check the ppropriate box: Type of project(required): 1. 1 am a employer with 5� 4• ElI am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 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.. workers' comp. insurance. 9. ❑ Building addition [No workers' comp, insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t. employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. ' t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. xContmctors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AM Yu/Ca. P 4 l 0", ,(/O.." (;::z o/pg / Policy#or Self--ins. Lie#: C P� T. _ Expiration Date: /'i� � 3/ .Zp/ Job Site Address: (CA e S W/.+cl City/State/Zip: /f mPAIIS p 6 t 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 u e the ins and penalties of perjury that the information provided above is true and correct Si gn afore: 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 S. Plumbing Inspector 6. Other Contact Person: Phone#: a Information and Instructions 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 r or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean 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 chapter152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptabl e.evi deuce 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 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 caII 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 bum 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 rt Depament of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-490.0 ext 406 or 1-877-MASSAFE Revised 5-26-OS Fax 4 617-727-7749 www.m:ass..gov/dia Client#: 123398 ROBERTCHIL7 ACORD,, CERTIFICATE OF LIABILITY INSURANCE D TE(MM0��") 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 NAME, Nancy Matanes HUB International New England Pe,HON Ext:508-235-2274 FAX No: 866-379-3254 222 Milliken Blvd ADDRESS: Nancy.Matnaes@Hubinternational.com Fall River,MA 02722 PRODUC R 508 235-2200 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Union Insurance Company Robert Childs,Inc.PO Box 1431 INSURER B:Acadia Insurance Company 31325 169 Great Western Road INSURER C: South Dennis,MA 02660-1431 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS.IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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 DDL UBR POLICY EFF POLICY EXP POLICY NUMBER (MMIDDNYM JMMIDDIYYYY) LIMITS A GENERAL LIABILITY CPA019895014 1/01/2011 01/01/2012 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $300,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO-JECT FX1 LOC $ B AUTOMOBILE LIABILITY MAA019895114 1/01/2011 01/01/2012 COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 1,000,000 BODILY INJURY(Per person) $ ALL OWNED AUTOS - BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY X HIRED AUTOS (Per accident)DAMAGE $ X NON-OWNED AUTOS $ $ B UMBRELLA LIAB X OCCUR CUA019895214 1/01/2011 01/01/201 EACH OCCURRENCE $1000000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1 OOO 000 DEDUCTIBLE $ RETENTION $ A WORKERS COMPENSATION WCA031676511 1/01/2011 01/01/201 X WCSTATU- ER JOT EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE s500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $SOO,000 A I Inland Marine CPA019895014 1/01/2011 01/01/201 Leased/Rented$100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Project Location:35 Mitchell's Way Hyannis,MA CERTIFICATE HOLDER CANCELLATION Town Of Barnstable DPW SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 800 Pitcher's WayTHE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE �. 01988-2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S545344/M477649 N M001 Cfr N w -� �' ( _ k ��"..// r xP, f s 1 -i P _ V- y 1a.. S PIA.,k .. - r .Y�00TLyI2097 ��`Y Offiee of Consumer Affairs dkS. .Busmess Hegulahon Y icense or,registration valid,#or mdmdul use only before the ez iration date.'Iffountl ietum to. HOME IMPR0IJEMENT CONTRACTOR ' +, P Reistratignpg'082 Tyke i Office pf Consumer Affairs`and Business,Regulation Expiration; 812/�D12 1ilclwiduala k' IO,Park Plaza �urte 5170' W 1_AMMER � SX i a [111 � .f '�f•' f f T3auicf Lammers 1 WiiJd nd Way a �� I7EL. Fnnrs MA D2660 P ry Notuand ithout Iguat � � kt Restricted to 00 MasSathusctts Ut'.liartint.nt of Ptinitc SAfctv ; 4 Board of Building:Re„ulations and Ctail lards �- Unrestricted 1 COnstru,ctron Supervisor License 1G-1 2 Family Homes :Wcense: CS 12209 z: Failure to possess a'cu°went edition of the AVID W 'HAMMERS{ Massachusetts State Building Code 1;'WINDMILI 1NAl'15 ?, is cause for revocation of this license:' $DENNIS MA 0266,0 i i a SL i Refer to: WWW.Mass:6ov/DPS F (t�mm s�uiner Trg 15668 A / NSTAR SUM SW3080A NSTAR SUM SW3080A 10:S2 33 a.m. 05-15-2008 STAROne NSTAR Way EL EC rRIc Westwcpd•Massachusetts 02090 GAS May 15, 2008 John Juros Dept Of Public Works 800 Pitchers Way Hyannis, Ma 02601 RE:ti-166-Stevens St,_Hyannis 180 Stevens St, Hyannis 190 Stevens St, Hyannis Dear John Juros: At NSTAR, we're committed to delivering great service. This letter serves as confirmation that, as of 5/15/8, the electric service to 166 & 180 Stevens St, Hyannis has been removed and electric service at 190 Stevens St, Hyannis was previously removed. Based on this information, there is no electric power at this address and you may proceed with the demolition. If you have any questions, please contact me at (888) 633-3797. Sincerely, K C Sousa New Customer Connects i �I I i �I it i //JUN-U4-2UU8 WED 12: 18 FM KEYSFAN ENERGY FAX N0; 508 394 5019 P. 01 r�cIJ,'101*"IaI r1 127 NVIiitc 1'a;li S0 0th V;'W iDC I101, Mn 02064 Jima 4, 2008' Nancy I ec; FAX: 50�1-790-6344 R1:: Cl fi(�ti_ui�:il 180 Stevens Strect, Hyannis is to c0111irrn that the natural gas lines to the above addresses have been cut ,aild C�Ip cd as requested. This w,:s done on May 30, 2008. IFyo u bave any tluestions Please call me at 508-760-7481, 01 � Sti;�,trc itiicl~-lullin C"icicl C'at�rdii'i;�toi 19�s11t3i'1l11ry1'Cil I _'�;V .a 1 V: L 7 f el A J V V J)�a V L J b V.�b e y♦ •�a a'a V v�a V u a H u V a . Me TO: Nancy Lee Cormier From: John Mawhinney CC: Datee 5/30/2008 Re: Drop removal To whom it may concern, The lines from the pole to the h"ouse aat18 and 180 Stevens Street in Hyannis have been removed according to your request on 512FVI Should you have any further questions, please feel free to call. i i John Mawhinney Technical Operations Supervisor 10 Old Town House Road South Yannouch,MA 02664 508-760-3400 ext3099 (C)617-279-6043 John_Mawhinney(4cable.comcast.com i r i i I I I t Page 1 of 1 Nickerson, Rebecca From: Juros, John Sent: Tuesday, June 07, 2011 1:02 PM To: Nickerson, Rebecca Subject: Fw: 166 Stevens Street, water service abandoned From: Keijser, Hans To: Juros, John Sent: Tue Jun 07 10:21:59 2011 Subject: 166 Stevens Street, water service abandoned Hi John, Please be advised that the water service to 166 Stevens Street was disconnected by the Hyannis Water System for the HYCC project several years ago which allowed for the building to be moved to its current location on cribbing at 35 Mitchell's Way, Hyannis, MA. As such the building has not been reconnected to the water system. Hans Keijser Supervisor Water Supply Division Hyannis Water System 6/7/2011 FROM :,HYANNIS WATER SYSTEM FAX NO. :50e 790 1313 Jun. 07 2011 01:06PM P1/4 pp Department of Public Works 47 Old Yarmouth Rd. P.O.Box 326 Water Supply Division Hyannle,MA. +3� ' 02SM-0326 Tr BAtIKA�B, _ TEL•508-775-0063 � •, Hyannis Water System Operations FAX:508.790.1312 .Tune 54 2008 Town of Barnstable Building Tnspec,-tor Town Hall Hyannis,MA 02601 Account# 60511.4— 166 Stevens Street Dear Sir: Please be advised that the water service at the above address is shut off, meter removed &the service line have been cut and capped on 6/2/08. The owner has informed us of plans to demolish the building. Sincerely, Judy Bent Hyannis Water System f�KNP WkNewater-PenMeauet Operated and Maintained by WhitaWatef.ine,and Pennidluek Water Services Corp, . ; FROM :,HYANNIS WATER SYSTEM FAX NO. :506 790 1313 Jun. 07 2011 01:06PM P2i4 Vt DATE 6/2/2008 TECH INITIALS MC MAP&PARCEL X 309003 SERVICE ADDRESS 166 STEVENS STREET TAP# 5963 ABANDONED SErtVICI_ EXISTING CUSTOMER ACCOUNT# 605114 CUSTOMER NAME TOWN OF BARNSTABLE NEW CUSTOMER NAME MAILING ADDDRESS TELEPHONE# TYPE OF ACCOUNT ( ) RESIDENTIAL ( ) COMMERCIAL METER OUT OF SERVICE METER# 60199323 X TO STOCK ( ) RETIRED ( ) REPAIRED READING AT TIME OF REMOVAL 946 METER FROM STOCK METER# SIZE 5/8" REG ID# MAKE NEPTUNE BEGIN READ READ TYPE MANUAL RADIO AUTOMATIC REG ID# MXU# HEAD CHANGE ONLY OLD READ NEW READ Ar-10-1 66 l vCI�C� FROM HY,ANNIS WATER SYSTEM FAX NO. :508 790 1313 Jun. 07 2011 01:07PM P3i4 Hyannis Water System Operations WhilteWater • Pennichuck g Work Order A Gl�i Account Number: ��, b r ��,4 i�-.r �r ., a _ ;, ng , 1 1 Work Order#: HOWO_dbr. �' Street '' ±< � Physical Address: ,... , n n�R �°i.: Date: Owner's Name: First ,'RIM, Last: M Time: Owner's Address: Addr V '_� - _ Addr_2: I l gg�� ryrye�.�y�g� .. t, .. 3 City: 'F,11�lillt6!%�Piiz State: Zip: .�,I(sf�kt,'kP'-![I'a5�u �i��(!S: IYcK.1► . �/ _._. .... .. �' _ n' •�II :. �� Telephone#: r A !c,�Nnv! ;,.a;•a:.:�lf:" ��rfs;_k`'� 'ry�I�/� CellersName: «�e � '�4a� i�:::..w+if ._:..':Order Taken By: { Complaint and Location: as.,,: " u :.,� :a ( ' -- s'r. 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F,_'�:.:.ht.�la•:aa.'ri Materials Used, �, L ;� - a 1:1.'a•a° i e4? + �_�nr:n , dun lLwn rred!. { am. }r " $1 rt:Ec.,c'::,,;.�..•?;i;:;t; ��'� •?k� I'L'.r,, 6°n0�tle�+e �- II��{�f:• .i;, r Cost Of Materiels. ��n!:'o�ufr�e.?r��?�;; ',�..._=��?YaaN�'r,'��i��I�`irlF;Prfakf!,I;I� R .1�.':4��F:lua,,e��f,� �;;;1,.,:,!.;`.'<° ;!sa�' d t l C Time Date Completed: Irrr .1 me Completed; a.i i8 'r rS i'?Qili .5 Work Performed By: r I 1 Work Hours: '9 �' i/'�td' '..e 7rG Ir!�n6Gl�... I , FROM :HY, NNIS WATER SYSTEM FAX NO. :508 790 1313 Jun. 07 2011 01:08PM P4i4 DIn Safe Btu. to From: CallCeflteraDlgSafe.com Sent: Friday.May 30,2008 6:51 AM To: Dig Safe Bamstable SubJact: Regular Locate Request-20082208697 20082208597.)PG (67 KB) (DIG SAFE SYSTEM, INC — MA) 05/30/2008 07:51:04 2�BW HYANWT -CH -CL -CW -ON -RJ -TV --------------------------------------------------------------------- ***** RECULAR TIME. .07:51. DAT8. .05/.*.W2008 REQUEST NO. . .20082208597 STATE. . . . . . ... .MASSACHUSETTS MUNICIPAJ,ITY. .BARNSTABLE r ADURE:SS. .166 STREET. —STEVENS ST NEAREST CROSS STREET 1. .f3AS8ETT LN �. NEAREST CROSS STREET 2. .NORTH 5T i• --------------------------•---------------------------•--------------------- p NATURE OF WORK. .EXCAV TO RELOCATE HSE (3FT DEEP) I'. h EXTENT OF WORK WHERE. EXIST HSE IS LOC 6 1 AREA IS PREMARKED. .YES --------------------------------- --------------- ��------- or 9 ___..... START DATE. , . . . .06/04/2008 START TT.ME. .08:00 AA CALLER. . . . . . . . . .ROBERT HAYDEN �� TITLE. . . . . . . . .OWNER RETURN CALL. . . ..BET 7-8AM _ PHONE #. . . . . . . . .508-428-6380 (r e 9� (4/� FAX #. . . . . . . . .508-420-4414 ALT.'. PHONE #. . . .508-364-6307 EMAIL ADDRESS. . . CONTRACTOR. . . . . .HAYDEN BUILDING MOVERS f �L ADDRESS. . . . . . . . .BOX 496 CITY. . . . . . . . . . .COTUIT STATE. . . . . . . . . . .MA ZIP. . . . . . . . . . .0263.5 EXCAVATOR DOING WORK. .SAMF This Email has been scannod for all viruses by PAETEC Email Scanni.mg Services, utilizing MessageLabs proprietary Sky3can infrastructure. For more inform tiori on a proactive ant:i- virus service working around the clock, around the globe, visit rittp://www.p<�r_t=c.t�om. i I , . i �TKMETa,,� Town' of Barn-stable Regulatory Services n�xxsxesr� Thomas F. Geiler,Director Building Division Tom Perry,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 ,^ &I, ' c�w� n Pg,S")C'_ , as Owner of the subject.property hereby authorize �d -2,Yt d S to act on my behalf, in all matters relative to work authorized by this building permit application,for (Address of Job) 06 .6 F. I I Signature of Owner Date jo- ' l Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNEUERMISS]ON 4 � . Town of Barnstable o Regulatory Services ' Thomas F. Geiler,Director s.�xxsrwst.e. � buss. Building Division TED µA{ Tom Perry,Building Commissioner 200 Main Stmet,_Hyannis,MA 02601 www.town.barnstable.ma.us Office: 509-862-403 8 Fax: 508-790-6230 HO1t1EOWWER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: _ number street village "HOMEOWNER name home phone# work phone# CURRENT MAILING ADDRESS: eity/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work berfoiuied under the building permit. (Section 109.'L l) 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 minimtun inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Constriction Control. HOMEOWNER'S ExFmmbN .The Code states that: "Any homeowner performing work for which a building pamrit is required shall be exempt from the provisions of this sec6on.(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. 14any homeowners who use this exernption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Rcgvlations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the hDmeoWner hires unlicensed persons. In.this case,our Board cannot proceed against the unlicensed person as it Would with a licensed Supervisor. The homoowner 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 fonn/ccrtifrcation for use in your community. Q:forms:homecxrmpt ROBERT CBH DS,INC. P.O. BOX 1431 169 GREAT WESTERN ROAD SOUTH DENNIS, MA 02660 508-398-2556 .508-394-5317fax JUNE 23;-2011 TOWN OF BARNSTABLE REGULATORY SERVICES 200 MAIN STREET HYANNIS,.MA 02601 THIS LETTER IS TO NOTIFY THE TOWN OF BARNSTABLE; THAT DAVID LAMMERS IS HIRED BY ROBERT CHILDS, INC. FOR VARIOUS JOBS; IS ALLOWED TO PULL PERMITS FOR OUR COMPANY AND IS COVERED BY WORKMAN'S COMPENSATION. ANY FURTHER QUESTIONS, PLEASE CONTACT MY OFFICE. ROBERT CHILDS ROBERT CHILDS, INC. r %"08/14/2008 08:34 FAX 508 790 6226 TOWN MANAGER BUILDING 001/003 Date August 14, 2008 FAX Number of a es includin cover sheet S IO o: From: Town Manager's Office IGHWAY DEPT Town of Barnstable ARNSTABLE POLICE 367 Main Street YANNIS FIRE DEPT Hyannis, MA 02601 PWIADMIN phone: 508-862-4610 BUILDING DEPT Fax: 508-790-6226 ASSESSORS LEGAL LICENSING Reply ASAP Please Comment I REMARKS: Urgent x For your review P y leted/signed moving permit issued to (/ �� For your infdrmation and records I am sending a comp b for the following: Hayden Building Company 35-th Mitchell's V�l_ayyscheduled for August 19t" from >>house to!be moved){erne erom Stevens dates ofStreet August 0 and August 2,15t 9AM to NOON, with a 08/14/2008 08:34 FAX 508 790 6226 TOWN MANAGER BUILDING 002/003 t ` PERMIT TO MOVE BUILDING FEE ?r,1TION#(if applicable) MAP Sr LOT NO.WHERE MOVED ASSESSORS MAP &PAGE NO.OF CURRENT LOCATION_--- OF BARNS (Ter.The undersigned respectfully requests written permission to move a building over TO THE TOWN MANAGE er Ed. Cha ter 85,Section 18, The building the public ways in the Town of Barnstable under the provisions of General Laws(T )• p (multiple move, see reverse)shall be moved: TO: FROM: . ROUTE: Lenuth _L=-- W ids — Weight BUILDING SIZE: Height(loaded) d (See reverse for additional bui ings) O — TIME OF MOVE: DATE OF MOVE: / ALTERNA DATE(S) do APPL..ICANT DATE ADDRESS PHONE A ADDRESS OWNER The ep tment heads fisted below d y app ve the grand g of the above: ; DATE SUPERI TE NT OF D.P.W DATE T WARDEN � - DAT COM ONW TH ELECTRIC. DATE CHIEF F POLICE DATE BUILDING COMMISS NER. D TE _ NEW E GIfAN.P TELE HONE &OLD KINGS GHW Y (if applicable) DATE • DA E CABL ION' AT CHIE 0 FIRE DEPARTMENT risate) DATE LICENSING DIVISI (collect fee) _ OWNER OF ROAD A (P - nsurance including subcontractors. The name of thuvith the An original certificate of insurance shall be provided to the leTown Nlanager's office regarding workmen's compensation,f applicable public liability, automobile liability and any other app agent will also be supplied upon request. The Town shall determine the specific insurance limits throng consultation A dyn,imstrahve Services Director. fiC requirement for the raising and lowering of a_re newspaper as well as at least two on- On building moves over 18sfeence the appt loaded gcant shalltberresponsible'for notifying Y hours of move and wires (utility comp ass . ) Cage radio/TVEatiarrs to properly apprise the public of the impending moving activity(i.e date/s of move., roads affected).. !cable) has been issued on Permit CONINIONWEALTH OF MASS. building moving permit(if dpp 08/14/2008 08:34 FAX 508 790 6226 TOWN MANAGER BUILDING Q 003/003 building permit(if applicable)has been issued on ,Tr-). N'OF _— ` ` Street/Road,permit# for;,:`a•ew site on Demolition/Removal Permit(if applicable)has been issued on TOWN OF StreeuRoad,Permit# for the existing site on SECOND STRUCTURE WGT Moving date — Alternate dates— Dimensions I W H.L THIRD STRUCTURE WGT Moving date_— .Alternate dates Dimensions I— W H.L FOURTH STRUCTURE WGT Moving date Alternate date Dimensions L W H.L PERMIT I;the undersigned'Town Manager of Barnstable hereby give written permission to to move a buildin7 in the ways specified above upon the terms and conditions as set out in the applicatio and as listed below and t;pon the vote of the Town Manager. Witness my hand!this LAY day of d'�" C'9 JOHN C. KLEVIM TOWN MANAGER TERMS OF PERMIT This permit is issued tinder the following terms: 1. That the moving of t{te building be dote promptly and in a skillful manner with no unnecessary inconvenience to the traveling public rovided 2. That proper warning signs and-lights be set-up to guard the public safety and such police protection be p ns the Chief of police may require. 3. That the moving be rlorie under the sitpervisiot and direction of the Chief of Police and the Superintendent of D. P. W. be d harmless by the 4. Thatithis permission be given uponYhe express injury or propn that ehe Town rty damage shall isinglout of the moving of tie buildg gust all lihbility, statutory or otherwise,for personal tj p P indicatingornt of $. /f the move involves more than one structure, an addenda be ill,be move d or as{given clay, as well to the back as alternate dates necessitated dimensions of each structure and the number of units to by w�eatter-and uncontrollded circumstances(accidents, etc.) and Department Directors not less than 48 hours prior to 6. Notit<carion shall be Htade to the Town Manager moving date or alternate inove date. 2 .