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0311 OCEAN STREET
3 /I Town of Barnstable *Permit#91!V.5"05 70 Expires 6 months from IdateRegulato ces Fee3S s 1* BARN3rABI.E, ` O o AtE �,� Richard Acali,Direct Building Div><s'�n��RNst�� [� Tom Perry,CBO,- i ti'l ki CWmmissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL. ONLY -3�� D� Not Valid without Red X-Press Imprint Map/parcel Number Property Address, Q Residential Value of Work$—&—l—C)a Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address trSZ Contractor's Name Telephone Number go -7-S -7 of J70 Home Improvement Contractor.License#(if applicable)' Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: � I am a sole proprietor ] I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) .❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ® Re-side Q Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is require . SIGNATURE: lie Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 27ze Commorrivealth of Massachusetts _ Deparhmmit o,f'Itrdustrial Accidents f3,)7ce o,f fmwstigations 600 Washbigion Street y Boston,4 02111 ivivau niass_govIdia Markers' Ilampensafion Insurance Affidavit:B•uildersiCantractarslEIectricians(Plumbers APPEcant Infar-nation Please Print Legibly Na=(Busi=ss/0rganization/ladiYid*): CS Address: j 64 E Y t 1 1-( � City/Statelzip A_ Phone, _�^D -73 7 - 207 6 Are you an employer?Check the appropriat .box: Type of project(regnire�c T.❑ I am a employes vrith . ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time)-* - have hired the sub-contractors 2. I am a sale proprietor partner- listed on the attached sheet. I ❑Remodeling or ship and have no employees. These sub-contractors have g. ❑Demolition working for me in any capacity- employees and have workers' Building addition [No workers'comp.insurance comp-msuran - l . required-] 5. ❑ We are a corporation and its 1 -❑Electrical repairs or additions 3.❑ 1 am.a homeoum-er doing all work officers have exercised their 11-❑Plumbingrepairs or'additions myself[No workers'comp- fight of exemption per MGL 12_❑Roof repairs insurance required-]6 c.152, §1(4k and we have no employees-[No workers' 13.0 Other comp-insurance required.] *Any app€is nt&at checks box Kmast also filloutthe section below shnseingtile¢WG&erecompensatiaapolicginfotmZhM3_ 1 H meoamers who submit ihis affdatgt indicating they are doing&U wank and then ham aotside contractars nmst submit it new affidavit indicating sach- fCantrsctorsdrat check ibis box must attached au additional sheet shotvmg the name of the sub-ccntrxctao-rs and state whether or not those entities have empl yees.If the sub-coatr c rshave employees,they m istprimide their warkers'camp.policy number- I arrt ark erreploy�cr fltat is pro>zdrrt it�orkers'conrp¢rrsatiort irrsrrrarcce for arc}*¢nrpiny es. Belory is ilia policy and job site trcformathm Insurance Company Name: Policy t,*'or Self-ins.Lic-9: Expiration Date: Job Site Address: citylStatelzip: Attach a copy of the workers'compensation policy declaration page(shaving the policy number and expiration date). Failure to secum coverage as required under Section 25A of MGL c 152 can lead to the imposition of criminal penalties of a fine up to SI,500:00 and/or one-year imprisonment,as well as civil penalties.in the form of a STOP WORRY,ORDER and a fie of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA.for insurance coverage verxfrcatiom.. I dIV hereby c alder the arrd rattles ofFedwy thattha info nuatcoif proli&d abmv is true acid correct Signature: Date: as �S Phan ik Ofja"ciai use only. ,Do riot avrite in this area,to be campleted by city rartown ofj'iciat City or Town: Permit/License 4 Issuing Authority(circle one): 1.Board of HeAth 3.Building Department 3.iity1rawn Clerk d.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Ph-one#: Information and Instructions Massachusetts Geoeaal Laws cbaptar 152 requires all employers to provide woIIEeas'compensation for their employees. Pursaautto this stye,au.en playee is deed as"--every person in the service of another under any contract of hire, =Pre-ss or implied,oral or written.." An.errpluyer is defined as"aa individual,partnership,association,corporation or other legal entity,or any two or more Of the foregoing engaged is a joint enterprise,and including the,legal representatives of a deceased employer,or the receiver or trustees 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 - dwelTir,g house of another who employs persons to do maintenance,ce,construction or repair work on such dwelling house or oa the grounds or building appurtenanttTacmfn shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(S)also sues that"every state or local licensiag agency shall withlroId the issuance or renewal of a license or permit to operate a business or to construct buildings in the comurOnwealth for any applicantwho has not produced acceptable evidence of compliance with the m�rance-coverage required_" Additionally,MaL chapter 152, §25C(7)states"Neither the commanwealth nor any ofits political subdivisions shall enter into any contract for the performance ofpublic wow until acceptable evidence of compliance with the insurance.. re luu-1-Me nts of this chapter have Been presented to the contracting aufhol*-" Applicznts Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if, necessary,supply sub-contractor(s)mrne(s), address(es)and phone number(s)along with their certificates)of =r-an cz. Limited Liability Companies(LI.C)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,ate not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is regau-ed. Be advised that this affidayit maybe 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 retume d 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 mquir-ed to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their s elf-in saran ce lice-ose number on the'approprrate line. City or Town Officials . Please be sure that the affidavit is complete and pried legibly. Tkie Department has provided a space at the bottom of the affidavit y n ti da ' for you fll out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the peffiit�license ninnbez 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 mdicating current policy inlf6rma1ion(if necessary)and under"Job Site A damss"tie applicant should write"all loca±iOns'n (city Or town)-"A copy of the-affidavit that has be=officially stamped or.marlced by t ae,city or,town may be provided to the applicant as proofthlat a valid affidavit is on file for future permits or licenses A new affidavit must be filled Olt each year.Where a home owner or citizen is obtaining a license or permit not related to any business orr commercial venture (Le. a dog license or permit to burn leaves etc.)said person is NOT requircd to complete this affidavit: The Office of Investigations would like to thank you is advance for your cooperation and should you have any questions, please do not hesitata to give us a call The Department's address,telephone and fax number. The Cammmwemltit of Massachus-F--tts Depadment of lad zal A ridenta Qffice Of kvegdntio--= ��Q�asUingtQn Sty Bostou=MA G� I I I TtrL 4 617 727-4900 Qx' 406 or I--977-MASRAFF Fay 9 617-727 7749 Revised.4-24-07 p mar gQ �r as 'I 1 ` oelm tAy, snartsenar.E. MASS, Town of Barnstable Arfp�� Regulatory Services .Richard V.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 caner of the subject property hereby authorize Ca +�'' to act on my behalf,. in all matters relative to work authorized by this building permit application for: (Address of Job) 2"A 42qL.- AAq J� gig�atur of owner fto Print Nam If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPFILESTORMS\building permit forms\EXPRESS.doc Revised 040215 f . Town of Barnstable of; Regulatory Services 'THE Richard rOyy Richard V.Scali,Director Building Division * maxsrasr.E Tom Perry;Building Commissioner BIAS& v 16S9. � 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 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-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside;on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures.'A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for.compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. 1 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 I 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:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 r=.: �. U Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-049696 �+.r IN CMSTOPBER V COIL�Rj 383 OLD MILL RD OSTERVE LLE ba 022 r Expiration 05125/2016 commissioner ex,�rvnvi�za��ciletolG�o�� /L�aytac��caed�. Office of Consumer Affairs&Business Regulation License or registration valid for individul use only k-'OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: •156038 Type: Office of Consumer Affairs and Business Regulation ` xpiration: 5292Q-17 Individual 10 Park Plaza-Suite 5170 ! Boston MA 02116 CHRIS COL13ATH ' r'•r, _. `ice+'--^^--',,- CHRIS COLBATH 383 OLD MILL ROAD -- OSTERVILLE,MA 02655 Undersecretary Not valid without signature i I Town of Barnstable *Permit# 0 � to Q, Expires 6 in rthsf,�tr issue date Regulatory Services Fee ANSTASLE, MASS 9. ,0� Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner �'0Vv 't1;; 200 Main Street,Hyannis, MA 02601 �B www.town.barnstable.ma.us Office: 508_UyvaRR Fax: 508-790-6230 EN&ss PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address �j�I QC7 r y (_ V A-o il l s V"Residential Value of Work ��5O,c)6 Minimum fee of$35.00 for work under$6000.00 Owner's Name&AddressP� _ ( P n rS Contractor's Name S c /� co. Telephone Number —7!7—�-pp 67(/ �� / Ol, h Home Improvement Contractor License#(if applicable)_ , Construction Supervisor's License#(if applicable) if �/q 1� cy ❑Workman's Compensation Insurance Chegk one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will betaken to,%1- f,(uj.0 1 ❑ Re-roof(not stripping. Going over existing layers of roof] ❑ Re- 'de #of doors f s i Replaceme Windom'/doorsCideri.�U-Va1ue__t0kL9-_Y (maximum .44)#of windows ,, *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. opy of the Home Improvement Contractors License & Construction Supervisors License is . re uir d. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 070110 �anvr. ea � -"11-gcuse�a I'; -License or registration valid for individul use only — a� Office of Consumer�At�airs B s�ness e u anon {( before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Registration: T; �56038 Type: I. Office of Consumer Affairs and Business Regulation i 10 Park Plaza-Suite 5170 Expiration: =5729%2013 Individual i Boston,MA 02116 i C„ �.•`COLBATH i it CHRIS COLBATH\ 4, 383 OLD MILL ROAD OSTERVILLE,MA 02655 Undersecretary Not valid without signature i k- Massachusetts= Dcpurtrncnt of Public.SafctN Board of Building Regulations and Standards Construction Supervisor License License: CS 49696 _ n Restrictedto: 00 l ,� CHRISTOPHER W COLBATH 383 OLD MILL RDA OSTERVILLE, MA 02655 �-�- Expiration: 5/25/2012 ('MUMissiuncr Tr#: 26161 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 lease Print Legibly Name (Business/Organization/Individual): fx Address: 1 l City/State/Zip: SJC 4 Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.El am a employer with 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2X 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 mein.any capacity, employees and have workers' insurance. 9. ❑ Building addition [No workers' comp.in comsurance P• required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LF]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' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the 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 e DIA for insurance cov rage verification. I do her eb certify nder th aim nand enalties of perjury that the information provided abo e7.36, true and correct. Si afar : ,Date: Phone#: z 'l L 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#: F Town of Barnstable Regulatory Services anRvsz M Thomas F.Geiler,Director y MASS.s. g, �p 1639. �� rFv r9. a 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, k&V 4 , I'Cl�, as Owner of the subject property h f hereb authorize Y (f to act on my behalf, in all matters relative to work authorized by this building permit application for: -YA A 1A� YWA 6 �A 0 I (Address of Job) 2 Signa e o Owner . a Print a e i If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERM ISS ION SHE Town of Barnstable �pQ 1p�� y�P &dRegulatory Services BARNSTABLE, Thomas F.Geiler,Director q MASS. �A. 1639• A,� Building Division 1Fn 'y Toni Perry,Building Commissioner 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 y e The current exemption for"homeowners"was extended to include owner-occupied dwelling 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 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 r 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:h.omeexempt TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel CYRO Application # 0' Health Division Date Issued 7 Conservation Division Application F64__:!�g Planning Dept. Permit Fee 41-7 6 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village Owner� l � (` �`i Address Telephone p Permit Request S 1► �\ 1J' vLo C� C S1►� Square feet: 1 st floor: existing proposed b60 2nd floor: existing proposed Total new Zoning District Flood Plain 9 Groundwater Overlay Project Valuation /Do#°`')Construction Type W 00�f 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: QdFull ®"Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) © Basement Unfinished Area (sq.ft) `�q0 rr�*x 1 Number of Baths: Full: existing new Half: existing new Number of Bedrooms o : � existing _new � ,� � � Total Room Count (not including baths): existing "7 new First Floor Rc�'� Countc _c-� Heat Type and Fuel: A Gas ❑ Oil Electric ❑ Other t; Central Air: ❑Yes N No Fireplaces: Existing New Existing wood/coal stoves]Y ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ exi ting ❑Rew Pze_ rn 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 ' G n f(2- Gu�1a�1- Telephone Number > - 'T 7" ffl 9 Address f D\A < < License / L St L A s Home Improvement Contractor# f Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Z`l- G2 0 5 FOR OFFICIAL USE ONLY APPLICATION# { ' DATE ISSUED MAP/PARCEL NO. t ADDRESS VILLAGE e i OWNER DATE OF INSPECTION: 5 FOUNDATION FRAME ' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT L r ASSOCIATION PLAN NO. Town- of Barnstable Regulatory Ser,�ices Thomas F. Geiler, Director "ram 6 : Building Division Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 0260I* www.town.barn-La b l e.m a.us 'Office( 508-862-4038 Fzx: 508-790-623C PLAN REVMW Owner: T �)� Map/Parcel: I Project Address f b�E64• t Builder. C DL 94- 74 The following item' s were noted on reviewing: • c �. �AG-s. L�D C�-�i� G��rc s ��--. �6¢� rL9 S _ TO(STI IT-) G-. tp--D E " • • •�14- t— lJS i'��S - • ReYiewed by: Date: — J t The Commonwealth of Afassachusetts I Department of ln.dustriat,4ecidents Office of lnvestigations 600 Washington Street .. j Boston, MA 02111 f www.niass.gav/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectriciaas/Plumbers Applicant Information PIease Print Let-,My Name (Business/Organization/Individual): C ft f e-S /� � z f- - Address: ��Fx V 5—/r/ - City/Mate/Zip:&76- V I'l 4 Phone #: r56K Z)76 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I 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 $ ? ❑ Remodeling i ship and have no employees These sub-contractors have S. ❑ Demolition working forme in any capacity. workers' comp. insurance. g. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL I L EI Plumbing repairs or additions Myself. [No workers' comp. c. 152, §1(4), and we have no 12f] Roof repairs insurance required.] t employees. [No workers' 1311 Other comp. insurance required] *Any applicant that checks box 91 must also fill out the section bdbw showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc 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 their workers'comp.policy information. f am an employer that is providing workers'compensation insurance for my employees. BeLaw is the policy andjob site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date- Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,00 and/or tine-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 her c under the p nd penalties of perjury that the information provided above is true and correct- Sienature: Date: p Phone#' C�VR' a2 b 7% Q lciat 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. 13oard of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other r Massachusetts- Department c Public uh iicl Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 49696 Restricted to: 00 CHRISTOPHER W COLBATH 383 OLD MILL RD OSTERVILLE, MA 02655 ' t Expiration: 5/25/2012 Conunissi"ner Tr#: 26161 Office of�ofouulmlve)rA airs Vin� egu ati'"on License or registration valid for individul use only Tj HOME IMPROVEMENT CONTRACTOR Ii. before the expiration date. If found return to: Registration: -_;156038 Type: Office of Consumer Affairs and Business Regulation Expiration: 5/20/2013 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 C CHRIS COLBATH 383 OLD MILL ROAD 4 OSTERVILLE,MA 02655-. . r =- Undersecretary Not valid without signature _- 1. i _.� ���y{{qg���``j� g` :/fit SAW itlilt tr— a rlil . �r Rp jog ` 74 . J _ . we s j r y r ' -a� _ ? �.r f Town of Barnstable Regulatory Services t aA.kxsus[..E. M g Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 vh w.town.barnstable.ma.us Office: 508-862 4038 Fax: 508-790-6230 Property OwrierMust Complete and Sign This Section If Using A Builder as Owner/f subject.property hereby authorize 67-1. rip ._ �`l �7 to act on my ea bhlf , in all rrratters relative to work authorized by this building permit application for. Address of job ASof Owne ate 6 Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION ray Town of Barnstable �4af,f Regulatory Services s.&RxsrAsLE, ; Thomas F. Geiler,Director WAS � t63p. ,0 Building Division PrED µA{k Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA.02601 www.town.barnstable-ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOi\ OWNTER LICENSE EXEMPTION Please Print DATE-- JOB LOCATION: number street vil lage "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code j 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. DEFINTI!ON OR HOMEOWNER Persons) who owns a parcel of land on which he/she resides or intends to reside, on which th-cre 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 constrticts more than One home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Of5cial on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the buildinu permit. (Section 109.1.1) The undersigned`Homeowner"assumes responsibility for coupliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies tbat.he/she understands the Town of Barnstable Building Department r13111 UM inspection procedures and requirements and that be/sbrwill comply with said procedures and requirements. •F '2, y ,. Signatiirc of Homeowner Approval of Building Official .4 Notc: 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. HOMMOWNER'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.(Scctivn 1D9.1.1-Ucrnsiiig of construction Supcnrisors);provided that if the home0Vgner engages a parson(s)for hire to do such work,that such Homeowner shall act as supervisor."- Many homeowners who use this rxcrnptian an unaware that they arc 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 homcowncr hires unlicensed persons. In.this case,our.Board cannot proceed against the unlicensed person as it would with a licensed y Supervisor. The homeowner acting as Supervisor is ultimately rcsponstble. To ensure that the homeowner is fully zware of his/her responnbilitics,many communities require,as part of the permit application, that the hOmenwner certify that bdshe understands the m9porusbilitics of a Superrisot. On the last page of this issue is a form currently used by scvcral towns. You may care t amend and adopt such a fom-Vccrtification for use in your community. Q:forms:homccxcmpt t L a c, f �q&4 p� pa5�� �s i MON 3 3 pI 1 DC- . 4-o iat� r I { j - - 3 i 3 � r r { i } I ' ? i f i ti 1 a j S 1 3/ig Y�rr �a!�s V-,oiSQ- ( I 1 1 7-7 i + - f —' t _ • �1. , ...yt� ' ; '{ Y, - r s r r �Y,, ISa , f I E -. . 1. 1. 1 • 1 Y Y .t 11•� ;,t, oF�► , Town of Barnstable *Permit# F� Expires 6 m nA rvm issue .date Regulatory Services Fee LIHNSMELE, MASSr� l � Thomas F. Geil'er,Director ^l 1 A�fD MA'S 6 Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number V Property Address Ail 5 Residential Value of Work Minimum fee of S35.00 for work under S6000.00 Owner's Name &Address Contractor's Name - YL j f' Telephone Number -iMY—7 j 7--Ro Z Home Improvement Contractor License#(if applicable) j S 6 d Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance ,MPE PERMIT Check one: �� [�I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) , El Re-roof(stripping old shingles) All construction debris will be taken to 7wtyo , LJ�L ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Window door iders U-Value " "� (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i•e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of th ome Improvement Contractors License & Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\ ut ding permit formslEXPRESS.doc Revised 070110 Irk The Commonwealth of Massachusetts E ^; i Department of Industrial Accidents s Office of Investigations 1 ,it PJ i 'sE„ SOt? Washington Street Boston, NIA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LelZibly Name (Business/Organization/Individual): Address: 3,k3 City/State/Zip: � � �/IS 1 Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6 ❑New construction employees(full and/or part-time).* have hired the sub-contractors e 7 � Remodeling 2.91 am a sole proprietor or partner- .$ listed on the attached sheet. ship and-have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. g. Building addition [No workers' comp. insurance 5., El We are a corporation and its officers have exercised their 10.❑ Electrical repairs.or additions required.] of 3.0 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' cor' c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.]'t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#l 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 chock 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site + information. Insurance Company Name: Policy#or Self-ins. Lic:#: Expiration Date:, Job Site Address: City%State/Zip: Attach a copy.of the workers'compensation policy declaration page (showing the policy number and expiration date). Failure to.secure coverage as requiredunder 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. Ldo her e rtify n er the p ns nd p nalties of perjury t .1-the information provided above is true and correct. P Signature: Date: / �l Phone#• �' 37 0 7 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 Phone#: 'i ,.. i 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 apartrnents 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, §2-5C(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 carry workers' compensation insurance. If an LLC or LLP does have employees,a policy isTequired. 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 iii 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 5-26-05 . www.mass.gov/dia J- THE,, Town of Barnstable Regulatory Services 9sr �, Thomas F. Geiler,Director Eo; A. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, lZ /zS , as Owner of the subject.property hereby authorize �'r /� 2. �` f to act on my behalf, in all matters relative to work authorized by this building permit application for- (Address of Job) l LOl 5igna Owner Date Print N If Property Owner is applying forperrnit please complete. the Homeowners License Exemption Form on .the reverse side. Town of Barnstable �ofTME 1p�y y�4 0 Regulatory Services Thomas F. Geiler, Director rsAss Building Division Tom Perry,Building Commissioner 200 Main-Street,_Hyannis,MA 02601 pt ww.to wn.b arnstab l e.ma-us Office: 508-862•4039 Fax: 508-790-6230 HOhIE04INER LICENSE EXEMPTION Please Print DATE: JOB LDCATION: number street village "HOMEOWNER": name hone phone# work phone# CURRENT MAIIING ADDRESS: cityhown . state ap 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 Persons)who owns a parcel of land on which he/she resides or intends to reside, an 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 constrgcts more than one home in a two-year period shall not be considered a bomeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Bolding Official, that he/she shall be responsible for all such work performed imdcr 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"certiEcs that.be/she.umderstands the Town of Bamstablc Building Dcparauent minimum inspection procedures and mgtiiremcnts and that he/she.will comply with said procedures and. requirements. Signature of Homeowner Approval of Bmlding•O>gicial 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. HOMEOWKER'S EXEMPTION .The Code states that: "Any homeowner performing work for which a building permit is required shaD be exempt from the provisions of this sccdon.(Scction 1 og.1.1 -Licensing of construction Supervisors);provided that if the homeowner engngrs a pc sons)for hire to do such work,that such Homeowner shall act as supervisor." 1,lany homeowners who use this exemption are unaware that they arc assuTning the resporinbfHdes of a supervisor(see Appendix Q, Rules&Rcgblations for Lice nsing Canstruction Supervisors,Section 2.15) This lack of awanmess often results in serious problems,particularly rs When the homeowner hires unlicensed peons. In this ease,our Board cannot proceed against the unlicensed person as it would with i licensed Supervisor. The homeowner acting as Supervisor is ultimatcly responsible. To ensure that the homeowner is fu11y aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that ha1she 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�certifieation for use in your cotrununity. Boar of m mg egu a ion an an arils"� " HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only I before the expiration date. If found return to: i Registration: 156038 Board of Building Regulations and Standards Expiration' 5/29/2011 Tr# 283569 One Ashburton Place Rm 1301 Type: :Individual Boston,Ma.02108 — CHRIS COLBATH CHRIS COLBATH 383 OLD MILL ROAD', OSTERVILLE, MA 02655,, .,,- �� ���✓�` '� Administrator Not valid without signature t_ .'`.. �'lassachusctts- . Board Dclrt►iment oJ'Puhlic oi'Buildin RC,, Satet� Construction ^ulations and Standards ction Supervisor License License: CS 49696 Restricted to: 00 CHRISTOPHER W COLBATH 383 OLD MILL Rp OST n ERVILLE, �y MA 02655 Expiration: 5/25/2012 Tr#: 26161 .r pi THE 3 • BAHHSTA.BLS • , 33# y MASS. °off 1639• F�61AY A" TOWN OFFICES 397 MAIN STREET (e17) 775-1120 ex. 128-129 HYANNIS, MASS. 02601 i October 21, 1976 Mr. Roger Stening 311 Ocean Street Hyannis, MA 02601 Re: Work prop9sed_.°at3110cean•-5t:=;:- yanns, Mass. Dear Mr. Stening: It is the opinion of the Barnstable Conservation C Tnission that any construction, grading or other alterations of existing conditions at 311 Ocean . St. , Hyannis will require a filing under Gen, Law, Ch. 131, Sec. 40 and Article XXVIII of the Barnstable By-laws. Forms for filing are available from the Commission office in the Thwn Office Building. If you have any questions, please do not hesitate to call. Sincerely, LCD/es Lee C. Davis, Chairman cc: Barn. Bldg. Inspector l aF Town of Barnstable * � - Permit F.Vb s 6 monow froei law Regulatory Services - Fee `S•MASS. . 0 C) s Thomas F.Geile r he• � i Director • Building Division TomPerry, Building Commissioner - 200 Main Street-H Offfce: 5084624038 �, Fax. 508 790-6230 ®VVfV V` EXPRESS PERMIT APPLICATION" - REalDENTIAI.ONLY OF MAIS NotVagd wMoutRaxpresslmprint p/PazcelNumber perty Address ©CP(a v-, S�e e - Residential Valise of Work Minimum fee of-$25.0o for work under$6000,00 ,noes Name&Address 311CP � S ntractoz!s-DJame . �1 C k�2�• r ►n.� ��2• Telephone Number Stiff-�t-�o'er�-1 s _ me Improvement Coniactor License#(if applicable) nstruction Supervisor's License#(if applicable) Worlonazt's Compensation Insurance ' Check one: El I am a sole proprietor ❑ I am the Homeowner { I have Worker's C//omp//ensati//on Insurance urance CompanyName (�I,be r 1 % /jut.7 -VI )rlaman's Comp.Policy# we Z - 3>> - `3l�-J od - 6 3 L( py of Usutranee Complf ante Certificate must be on file. =it Request(check box)UT 11 �,wee Cdbrk S�It-�`•.'�''(r':'� 14,t Re-roof(stcipgiag old shingles) All construction debris will be taken to 7/� <1 ti Z f-C-% ❑Re-roof(not stripping. Gomg over exist ag layers of roof) ❑ Replacement Windows. U-Vdue ( .44)- *Where required: Issuance of this p=dt does not exempt cornpUanee with other town department regulations,i.e,Mstoric.CmstrvatiM etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home improvement Contractors License is required. - pale 'o=gpmtrs dse063004 Town of Barnstable Regulatory Services saRMABM Thomas F.Geiler,Director MAM &639. .,�� 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 ABuilder I ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized bythis building permit application for- -3-\� o c �- (Address of Job) a 40fYeir Date -- - —Print Name. - —- - - -- - -- - - f ' Q:FORMS:OWNMERMISSION ��e C/JO�i�t4ltOOGllP.cLG�/t O�/��DJ��csauJe�3i Board of Building Regulations and Standards License or registration valid for individul use only 4 before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Registration: 133851 Board of Building Regulations and Standards Expiration: 8/17/2007 One Ashburton Place Rm 1301 Type: .Private Corporation Boston,Ma.02108 NICKERSON HOME IMPROVEMENT MARK NICKERSON 12 COMMERE DRIVE. ORLEANS,MA 02653 Administrator Not valid without signature Q II Page No' o of Pages: NICKERSON HOME IMPROVEMENT,INC. F q124880: . 0 D adk 2476 HYANNI4. S, (508) 790.5880" Fax (508).255 5107 PHONE t)gTi ° Steven..Parks �a�t�t�7ra�N �fl05 3 i l'`Ocean Street ApLB. Same Hyannis MA 02601 SOB NUMRF_W Jt]8 PttONE; ..-. ... .. a ..a -.. .. .. .. .-. _ Strip shingles off entire roof(except area indicated in on enclosed pictures). Renail all loose sheathing Install 8"white aluminum drip edge on all lower edges Install 36" of ice&water shield on all lower edges Install black un�erlayment felt paper on stripped areas Install new flan es around vent pipes Install 25 year 3 tab Seal King algae resistant shingles on stripped areas All trash and debris will be removed and disposed of properly L ; All labor,materials and debris remova OPTIONS: To install 30 year Woodscape Series_ algae resistant architectural shingles add s ;io above Install ridge vent at roof peak for,—. __ per lineal foot PLEASE INDICATE SHINGLE COLOR AND YES TO ANY OPTION ON RETURNED PROPOSAL Only items specified above are i lud d in this proposal Rotted wood repair is not included in this proposal Materials guaranteed by manufacturers N Nickerson Home Improvement Inc. guarantees workmanship for 10 years WE PROPOSE hereby to furnish material and tabor—complete in accordance with the above specifications,for the sum of: W_ _. 00 Do�riafs dollars deposit•� upon signing,Progress payments upon request, balance upon eom letion horized All material is guaranteed to be as specified, All vrork to be completed in a professional 1 manner according to standard practices. Any alteration or deviation from above specifica- Aut icons involving extra costs will be executed only upon written orders, and will become an Signature extra charge over and above the estimate,All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado,and other necessary insuranco.our Note:(Is proposal may be workers are fully covered by Worker's Compensation Insurance. withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL. —The above prices,specifications < and conditions are satisfactory and are hereby accepted. You are authorized Signature-_ to do the work as specified. Payment will be made as outlined above. 11,06 Signature Date of Acceptance: IIIC 77 Assessor's map and lot.tnumber ..�.�..���...:1�..: .. . 'SN0l1b1n'038 ' . NMO1 aNV 3Q0� �l�lb'llNt/S Sewage Permit number ., C L.,.l, .lnG��r :�' ........ ` 31�f1S II 31011bH H11M 30NVIldWOO NI 03 lb -Q �FrTHE TO TOWN OF BA.RNSPAL S. . 8�SII3TODL8 i _ f r b``, BUILDING ' INSPECTOR O 39• o OPLICATION FOR PERMIT TO . 5r.(ST�.....G ..... .. ...... /(//4 (J{�.//off' _ M - ....i TYPE OF CONSTRUCTION ..... ...... ... ............:........ ......... ......... ......... .:...................................... ..7../.� ....... . b. ..................19.;/„G TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Locationl.f....... �r'7.. ..�/............................................................................................................................. ProposedUse ... - :�� .... ........................................................................................ Zoning District ��, . ......... ...... .....�.................................p...�............Fire District ........... . .: .�.-.—..........................,....(.... ............. Name of Owner Nameof Builder ............. ...........................................Address .................................................................................... Nameof Architect ...............................................:..................Address ....................................................:............................... Number of Rooms ..... .C� ........Foundation Q tom.......—. �.r.�C t C.}Y... 4 . ................. Exterior ..soofing ..W d. .J.....................:..................................... Floors . .N). .............................................:....................Interior ��......N..�� ..................................... Heating ...................Plumbing . ..' ....................................................... Fireplace ... " o....................................................................Approximate Cost .. ,. QS/ . .®........................... . . ..... Definitive Plan Approved by Planning Board ------------------_-------------19--------. Area ......4= /�....Sc ............ Diagram of Lot and. Bu lding with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 01 � o I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... ... . ... .. ...... ..................... Stening, Roger V. t • 19342 _ add to single No Permit for"....•............................... _ family dwelling ~ ............................................................................... 311 Ocean Street �N Location............................................:...................... .Hyannis ...........................Roger ........ _ ..........Roger V. Sten&g...R............ - • v �4� _ ` � , Owner .............................................::.................. - d _ frame Type of Construction ........................................... .......................................................... Plot ..... ....:n...... Lot ......... ..... June 28 77 Permit Granted'........................................19 Date of Inspection Date Completed ..... ,1 / � ........19 1 J - °PERMIT`REFUSED - ....................... ................41............. • ... 19 ......................... .................................................. . ..... _ ...... _ ' .. ........ " ...•...•....•.•..••.•..•. .,.. ..••..•......•.•••..•..........•..........•..•••.. ........................• • •.............................•.................. -!. Approved . ............................................................ ............ .`.. - .................... ........................................................ ; Assessor's map and lot number To:1 Ja � ' C 6~2 Sv f ♦ 111YYY„J// Sewage Permit number .............................................../ /* .......... �fTNETp TOWN OF BARNSTABLE ii • i BJHHSTABLE, i " E M 6 �' 9 . BUILDING INSPECTOR O� PY o f A f/) �// /. ���r, 1 // �C TGl/e APPLICATION FOR PERMIT TO ... ......a... ..................................... .. .... ...... ....... TYPEOF CONSTRUCTION .......................... .......................................................................................................... ...................19......:. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: • Location ..................r.:....`...-:..!T..........!.. ......................................................................................................................... Proposed Use ..../.... ......................... 11- ✓ ............................................................................................................. ........................ Zoning District .......0,.� .....................................................Fire District ......... ?.!'!............................................................ Name of Owner ..�... �F.t:.'` .�:!... C 1 1 Ca-''...Address ... �..�..�. ' .! ....................................................� lrA I ► Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... ` t2 t�c�tM. ( �/ Numberof Rooms .......................................:...........................Foundation ......:.............,...............:...........:............:................. Exterior ..4....�..t1 :j t�r1Aa�,1� 4 C._ k-�N,VY �1/ Roofing � ...... . Floors .....^!..1`.fa'.................rr.................................................Interior .. r� ) (? ... 4 ..................................... Heating ...........Ll...... ......!. ...(9 Cl...................Plumbing ../............�iNT, ....................................... ..... Fireplace �' �` �....................................................................Approximate Cost ... 6 Definitive Plan Approved by Planning Board ________________________________19________. Area .........! ?....... ...r.....:..... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAU OF BOARD OF HEALTH ` A ' .jut " � i C'V I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. -Name .................................✓............................................. Stening, Roger V. A=325-20 19342 add to single ' No ................. Permit for .................................... family dwelling ............................................................................... Location 311 Ocean Street ................................................................ Hyannis ............................................................................... Owner ..............Roger. . ..V.. Stening..... . .... .. ...... ............................. Type of Construction frame ............................................................................... Plot ............................ Lot ................................ Permit Granted ..........J�ne 28 1977 Date of Inspection ....................................19 Date Completed ................. ....................19 PERMIT R USED .................i�... ........ :............. ..... 19 ............D. .� . ........................... ................ . .................................................... Approved ......................7........................ 19 ............................................................................... ............................................................................... Assessor's map and lot number `.......... Sewage Permit number ........ ! T� .............................� Pyo*THEro�r TOWN OF BARNSTABLE ro4' O•w i SAHBSTABLE. i mum BUILDING INSPECTOR �'O yPY 14• L APPLICATION FOR PERMIT TO �Vw ..................................................................................... �....... .. ................. ......TYPE OF CONSTRUCTION �..� -...............19.7.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... ..�..1......... i .4 a ! d....�4,. \...c:....:...............................................................................:................. Proposed Use . ............................................................................................ . ......................................... Zoning District46 .......................................Fire District ......,... (�........... Name of Owner .:. t���` Y. /...�� lU �t r- Address .�..�.... : !41.. �..... <..�/ N ^� Nameof Builder ....................................Address .................................................................................... Nameof Architect ....... !.A. .. .................................Address .................................................................................... Number of Rooms ...... ..................................................Foundation ......,�5�....... ...... ....:.............. Exterior ..Vp - r.V... ,�, .L� .........................................Roofing ......... .. '.✓..�1..`1... v ...... .............. Floors //.AA rr .. ...` ...........................................................Interior .................................................................................... g ...... -ld.. .............. g x �/ Heating .. ..... .........Plumbin .... .......... .... .... .. ............................................ Fireplace .......y/ ............................................................Approximate Cost Q�..0.0o ......:. ................ .......................... Definitive Plan Approved by Planning Board ---------------------_----------19________• Area ..................:...................... . Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ID i a aG L �0 sT-, I hereby agree to conform to all the Rules and Regulations of the of Barnstab a egarding the above construction. Name .. ............................................ Stening, Roger V. ' 17559 remodel frame / No ................. Permit for ------------ / dwelling ' -------------------.------.. � 311 Ocean Street Location ---------------------.Hyannis � . . ...........................'.................................................'. V. Q {Jvvna, ----..�����—..�--������-----' Type of Construction .......... --���me..................... � w � --------------------------. .. � Plot ............................ Lot ----------'' � J ' � � ' Permit Granted --"Jamary..20.—..—'lg 75 ' . Dote of Inspection — -----.l9 � } ' Dote Completed A-Mb)'-----.lA � � � . ` < PERMIT REFUSED ^ ' ^. --------------------' lP � ' ^ � ~-------------------------' | �e ` | --------------------------. ^ ' � —.--------.--.,--..~--,—~—~--- � - � � ---------^----.------.-----.. � � � Approved .............................................. lg ' ------.-----------.-------.— � � � --------------'------~^'^'--''' � � <. _ ..'r`"""`_.. ,Y..'_�., -„ ",.-.�,ys'-" t�r..^'"�F'.;�31Tr�-i3'+..�--^S'""---u•y..--�y..F'-^"'�-«..-..�.-..�,,,,,..-...y.:a.;�,.�;.��a-'y,'w'74..�.-".,,,a�.n'c,�.f-':.r„q..,...�,.. .c.. .. «- --r�:,.y..h,s• Assessor's map and lot number .......................................... A/ Ile 7` Sewage Permit number ......... U� .. ...Cr *?NE.TO�yow ' TOWN OF BARNSTABLE Z BA"STADLE, • ,639. BUILDING INSPECTOR p M APPLICATION FOR PERMIT TO .. ....'......t.......� ...................................................................................... .......... ... TYPE OF CONSTRUCTION .. ��... ... ... ....l i..::...'.......n":... .................19..-.74 ... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: - �Location .........- a..'...� ......... ...(. f`w` .1.....: .!:...................................................................................................... ProposedUse r C.s �'....1(' .r ........................................................................................................................ 3 Zoning District ......... ......................................Fire District ............ Name of Owner �. ���4~..� ! ,\ r Aj:�..!�..1<- Address .. ?.�..�. ' /�if" � /:..........A�E J (` Nameof Builder l )3.f!/J - ..................................Address .................................................................................... Name of Architect ........:: G� � +!�................................Address .................................................................................... Number of Rooms ......: ..................................................Foundation ......r ".�t................ .................. Exterior . ....../- ., 1........ S�.........................................Roofing ..... Floors /' �t�1("}. ...........................................................Interior ........................... Heating r �a �.. � /.....J '.'�./V) .. ........Plumbing !' .. .! ........................................ Fireplace ...... �'` .. ............................................................Approximate Cost Ix Q Q V C1 ............. ............................................ Definitive Plan Approved by Planning Board ________________________________19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I � _ 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... /// .................. ! ............... Stening, Roger V. No ,17.559 Permit for .......remodel ...........frame dwellin&.......................... Location ..........:311 Ocean\,Street ......... . ............................ H annis .......�s....................... Owner Roger. V.. S.t .... n&................. ................ Type of Construction ....... ...rame ........................ Plot ......................... Lot ................................ Permit Granted Y J quar....20.........19 75 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................ ...................... 19 ... ......................... ................................................. ............ 7.. .................... . -................................... ...........'....... f \ Approved ................................................ 19 ............................................................................... �. ,N 4�. ; . ...,- �. .' .� � . .,� �. ., �* s.�a� :�rc�-fl=�;; Y4 . r ;. i © a'' ©��y p y ' _•; ��� Y � 1 � �^ � Y� 7 � � [�j] �� „� - .,, . ;_ �� '�r� -� . � €' .• 4 i„ '' 4 c , � N0 , x F & r +'"�J RECEIVED FROM` LLARS �^ � `s-�,�'� � a ,� s �•., was � Account Total $ 71, Amount Paid $ r c{ 4r�a Balance Due �� The Town of Barnstable r • „& Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner TOWN OF BARNSTABLE Permit: SOLID FUEL STOVE PERMIT Date: Fee:025:vev Owner: j Phone:(212 7 Address: 3 I / OC eo--L f Village:_H ez r, Map/Parcel: Date: Stove A. New/` sed � B. Type: diant/Circulating C. Manufacturer: /'?l cG. /„ s Lab. No. D. Model No.: -Fe P11 (,Jn t1d 3 Chimney A. New/ xistin (If existing,please note date of last cleaning B. Flue Size C. Are other appliances attached to Flue? A/o re-fab Type and acturer E. asonry: Line nlined Hearth A. Materials: �'�,.�,,� c 7-1'/,e B. Sub Floor Construction: U)emn-z) Installer Name: /d/ e S' Address: 3// Dcea-► Phone: -772 -Z02 y Location of Installation: ?// ©re«, S4> APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Stove.doc TO ALL NEW BUSINESS OWNERS DATE: y Fill in please: z� a� ky; as APPLICANT'S � � , YOUR NAME:°' E °2 i e- BUSINESS v r} YOUR HOME ADDRESS: 3 N Sf #.4 TELEPHONE �4„` ..` Tele hone Number Home 7/ 'u NAME OF NEW BUSINESS q N; 2r 4m TYPE OF BUSINESS ov) l;we see vi tv IS THIS A HOME OCCUPATION? YESNO Have you been given approval from the building div'sion? YES NO u2 Go ADDRESS OF BUSINESS L g - i -eaw► 41 Sr-� MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below,you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall). You MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. - [corner of Yarmouth Rd. &Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER'S OFFICE This individual has Deeq informed of an permit requirements that pertain to this type of business. Authorrized Si ature* COMMENTS: 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: Business certificates [cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. -it does not give you permission to operate-you must get that through completion of the processes from the various departments involved. **SIGNIFIES APPROVAL FORA BUSINESS CERT/FICATE ONL Y.