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Home My WebLink About0021 PLEASANT STREET TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Parcel C' ppIlcaMap tion # Health Division Date Issued Conservation Division Application Fee Planning Dept: Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 01 RG501V " Village G/lf)� � �C�1 Owner Address Telephone �� 6 n Permit\RequestIj 1 � 5,0 Square feet: 1 st floor: existing proposed 2nd or: existing proposed Total new Zoning District Flood Plain -�Grroundwater Overlay Project Valuation � � ®� Construction Type —c� 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' ighway:�Ell YeQ❑ No >+ [ ;2M Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Others o Basement Finished Area (sq.ft.) Basement Unfinished Area (sq ff) w Number of Baths: Full: existing new Half: existing -new_ Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) <` T Name Telephone Number �� Address License# to) Home Improvement Contractor# ,/ d"1 Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .SIGNATURE DATE 1 / i r e FOR OFFICIAL USE ONLY s `APPLICATION# DATE ISSUED . MAP/PARCEL NO. h - f ADDRESS VILLAGE T OWNER k F. DATE OF INSPECTION: w, FOl1NDATION_�'t? F FRAME M x' k I INSULATION r FIREPLACE Y ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massacliuseft Depart of Industrial Accidents Office of Investigations +600 Washwgton Street _ 1lostrrr4 MA 02111 fin musmgo►I'dia Workers' Compensation Insurance Affidavit:Builders/ContractorsfEIect6cians Ptambers Applicant Information Please Print Legibly Name(Bus_ om7l&vidual): Ad&css: 1 City/State/Zip: CRW+ ph—##: l l 9 Are a an employer? the a opriate box: Type of project(required):1.LI 1 am a employer with 3 4. ❑I am a general contractor and I employees(full and/or part-time).* have hired the sub-cautrsetofs 6 ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7- ❑Remodeling ship and have,no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have wodms' 9. ❑Building addition [No workers'comp.ina n-anre comp-insurance., required] 5. ❑ We are a corporation and its 10_❑Electrical repairs or additions 3.❑ I am a homeowner doing.all work officers have exercised their I l..❑Plumbing repairs or additions myself[No workers'comp- right of exemption per MGL 12:ElRoof repairs insurance required.]l c. 152, §1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required]. `Any agpTncahrt that checks bra€#1 must also fill out the section below showing their woikeW compensation policy inf� Iiomeoamars who submit this affidavit indicating they am doing hall work ahad then hike outside contractors mast submit a new affidavit indicating such_ tCantractors that check this boa most attached an additional sheet showing the name of&e sub-cou tacoors and state whedw ornot those ealities have employees. If the sub-contractors have employees,they smut provide their worker'comp.policy mother. lam an employer that is providing workers'compensation insurance for my enrpfoyees Below is the policy and job site informadoiL Insurance Company Name: Cl Policy#or Self-ins.Lic.#•. C 1"I c�(6Q®1 ExpirationDate: Job Site Address: CityfStatelZip: *13 o �� 0 ' Attach a copy of the workers'compensation policy declaration page(showing the policy numlk and exp&twn date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition ofcriminal penalties of a fine up to$1,500 and/or tine-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250. a yrathe violator. Be advised that a copy of this statement may be forwarded to the Office of Iacestgations f f Dn¢+xanrE coverage verification. I do hereby c �J the pains and penalties ofperjury that the information proiritd lbove is true.and correct Simature: i Date: I 1 ��rcial use duty. Da not sprite in this area,to be completed by city or town ofliciriL City or Town: PermitUcense# Issuing Authority(circle one); 1.Board of Health 2.Building Department 3.City town Clerk_ 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 r 1/14/20,14 12:01 Bryden and Sullivan Donna Setour->Tim lfl JOHN-10 OP ID:IDS CERTIFICATE OF LIABILITY INSU 0111411 NCE DATYYYY) 01H4114 - 10 - ONLY AND CONI-EK5 NO KIr.HT3 OPIUM T99 ewrZE HOLI T-rfmr CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SJ AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: the certi icate holder is'an ADDITION7T INSURE,the po icy le$ must be endorsed. S 10N 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 ndorsemen s. Bryden&Sullivan ins Agency Fax: 508-790-141 PHONE 88 Falmouth Road Atc No Ext: (AIC,No): Hyannis,MA02601. Hyannis Office INSURERA:NGM Insurance Company 14788 INSURED Timothy P.Johnson Construction INSURER B:Citation 40274 180 Megan Road INSURER c:Associated Employers insurance Hyannis,MA 02601 INSURER 0: INSURER E: INSURER F: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD fA ERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, XCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 COMMERCIAL GENERAL LIABILITY MPT7064K 11/10/13 11/10114 PREMISES Eaocourrence $ 600,00 CLAIMS-MADE OCCUR - MED EXP(Any one person) $ X Business Owners PERSONAL&ADV INJURY $ 2,000,0 GENERAL AGGREGATE $ 4,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 4,000,00 X POLICY . LOC $ AUTOMOBILE LIABILITY Ea accident 1,000,00 B ANY AUTO TBCUBCLRYL 04/28/13 04/28114 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Par accident) $ NON-OWNED PROPERTY GE HIRED AUTOS PAUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTI ERS ENSATI AN EMPL YER 'LIABILITY YIN T YLIMITS Ci OFFICERIMEMBER EXCLUDER CUTIVE N NIA CC50050114562013A 11/02113 11102/14 E.L.EACH ACCIDENT $ 100,00 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,00 If yes,describe under PT T SWI w E.L.DISEASE-POLICY LIMIT 50 0 OO DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) ertificate issued for insurance verification purposes BARNS-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Mai In Street AUTHORIZED REPRESENTATIVE Hyannis,MA 02601 Hyannis Office I O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo le registered marks of ACORD Mass. Corporations, external master page Page 1 of 2 William Francis Galvin Secretary of the Commonwealth of Massachusetts HOME DIRECTIONS CONTACT US Search sec state.ma.uS i Search ! Corporations Division Business Entity Summary ID Number:001078732 ( Request certificate New search Summary for: CAPTAINS ROW REALTY LLC The exact name of the Domestic Limited Liability Company(LLC): CAPTAINS ROW REALTY LLC Entity type: Domestic Limited Liability Company(LLC) Identification Number: 001078732 Date of Organization in Massachusetts: 05-08-2012 Last date certain: The location or address where the records are maintained(A PO box is not a valid location or address): Address: 2167 FALMOUTH RD. City or town,State, Zip code,Country: CENTERVILLE, MA 02632 USA The name and address of the Resident Agent: Name: JOHN VIOLA Address: 2167 FALMOUTH RD. City or town,State, Zip code,Country: CENTERVILLE, MA 02632 USA The name and business address of each Manager: Title Individual name Address MANAGER JOHN VIOLA 2167 FALMOUTH RD.CENTERVILLE,MA 02632 USA MANAGER ALLISON VIOLA 2167 FALMOUTH RD.CENTERVILLE, MA 02632 USA In addition to the manager(s),the name and business address of the person(s)authorized to execute documents to be filed with the Corporations Division: Title Individual name Address The name and business address of the person(s)authorized to execute,acknowledge,deliver,and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address r Consent r Confidential Data r Merger Allowed 0 Manufacturing View filings for this business entity: Annual Report Annual Report-Professional }; Articles of Entity Conversion g Certificate of Amendment J View filings Comments or notes associated with this business entity: http://corp.sec.state.ma.us/CorpWeb/CorpSedreh/CorpSummary.aspx?FEIN=001078732&... 1/14/2014 f Mass. Corporations, external master page Page 2 of 2 New search William Francis Galvin,Secretary of the Commonwealth of Massachusetts Terms and Conditions r . http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=001078732&... 1/14/2014 JRN-14-2014 13 :00 FROM:JUNO OCERN WRLK 5616227399 T0:15089572859 P.1/1 HYANNIS EAST END CONDOMINIUM ASSOCIATION P.O. BOX 781 HYANNISPORT, MA. 02647-0781 1-14-14 Town of Barnstable Building Division 200 Main Street Hyannis,Ma.02601 This is to authorize Timothy Johnson to perform the roof replacement located at 21 Pleasant Street Hyannis.Ma. 1y yours, John T. Viola, Chairman Board of Trustees Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS=101696 TIMOTHY P J_11�1SON 180.MEGAN RD Hyannis MA 02601 t `c J � Expiration Commissioner 08/23/2014 I le cpami?wracuetcCG�,o�Caac�uaeGYa'I ' Office of Consumer Affairs&Business Regulation License or fSgi§fFatpon Yl+jid for individul use only ()ME IMPROVEMENT CONTRACTOR , � 41 be�orR the.e p"ration date.:If found retyrn o: egistration: 15gg82 1 ype: Office of Eonsumer Affairs and J�gstness.Regulation xpiration =6/13/2014 DBA 0 Park za Siii Ii�osfon 02116 _ y 1 PI I . - 5170 TIMOTHY.P JOHNSWC.0NSTRUCTION -a- CIMC?l'HY JOHNSON E y t7 180 MEGAN.RD s lid: HYANNIS MA 02601 Undersecretary Not li wi hoot signature_ F -i r16rZ01O UU.Ou -PUU UT01 —7DFWKT rlULJZaHU1MUM I ram- � rF1QC U1IC!1 7-79 p3/ 3�. K3e a ZONING MiGION TO: Linda'Edson FROM: Trim M. Gomez - Leased Housing Coordinator RE: Legal Rental Unit Verification Date: d _ ,!Address: �o2l /0� Village: Unit Type: Bedrooms Size: Map & Parcel No.. („-A(3—ATO Aq6 �� t The owner of the above listed property is entering into a contract witla us for the rental of the property as listed above. Please vex*by signing below that the unit is legal and meets all zoning requirements for a rental in the town of Barnstable. If it does hot, please list reason here: U o�� b )-( k you fo your assistance in this matter. 8i lire Print name Date VIA FAX: 790-6230 MRVr Section 8 Rev.-8/06 07-22-1997 12:55PM FROM BARN HOUSING A_ITHORITr' TO 97306230 P.17 BARNSTABL OUSING AUTHORITY LEASE® H®USIEPARYMENT GLEPHONE (503) 771-7292 14� SOUTH STREET (505) 778-9312 HYANNIS MA 02601 TO: Gloria Urenas FROM: Leila Botsford, PHM, Leased Housing Coordinator RE Verifying legal rental unit DATE: July 22, 1997 ADDRESS: 21 PleasaPlt_Street VILLAGE: HyannlS Unit type: BEDROOM SIZE: 1 Map & Parcel Number:3a 7 tm O� /7 The owner of the above listed property is entering into a contract with us for the Fental of the property as listed above. Please verify by signing below that the unit is legal and meets all zoning requirements for a rental in the town of Barnstable. If it does not, please list reason here: ,,;anu for your assistance in this matter. nature Print name 7 -------------------------- bate VIA FAX: 790-6400 SEC.8 Rev 1!97 [ ]�[R327 246 . OOH ] • LOC10247 MAIN STREET CTY107 TDS] 400 HY KEY] 243597 ----MAILING ADDRESS------- PCA] 1021 PCS] 00 YR] 00 PARENT] 0 BURKE, JAMES M & JONES S C MAP] AREA10180 JV1315304 MTG12001 TR MAIN ST RENAISSANCE TR SP1] SP21 SP31 36 MOONPENNY LA UT11 UT21 SQ FT] 813 CENTERVILLE MA 02632 AYB11920 EYB11980 OBS] CONST] 0000 LAND IMP 42800 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 42800 REA CLASSIFIED #BLDG (S) -CARD-1 1 42, 800 ASD LND ASD IMP 42800 ASD OTH #UT UNIT 8 BLDG B DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL 21 PLEASANT ST HY TAX EXEMPT #RR 0952 RESIDENT'L 42800 42800 42800 *EAST END CONDO OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE106/84 PRICE] 250000 ORB14133/133 AFD] I G LAST ACTIVITY] 12/17/96 PCR] N