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Home My WebLink About0074 RIDGEWOOD AVENUE Rve TOWN OF BARNSTABLE BUILDING ARMIT APPLICATION Map Parcel Application # Health Division Date Issued '7-/t` Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis JLM&41 Project Street Addresses Village Owner Address Telephone .S''l p / 777,V— Permit Request /u��'/�//' LYc�? ,/2 2 z � /✓s 1 ��//y�d S� �� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay. Project Valuation _Z®ao, Construction Type ®� Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type:.Single Family a-' Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 0-No On Old King's Highway: ❑Yes @-No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count 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 �tin� --• c��9 ""` " } APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �Wz�o Cy1 ,.4, , -,_4a Telephone Number ✓'a� 7 S%� J Address ,/S/ a 941 Al �[[,� License # Home Improvement Contractor# 44'IJ 34- 7 EmailYLr ",a A;jam l�z,¢� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /✓��f J FOR OFFICIAL USE ONLY APPLICATION # r DATE ISSUED i MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable s Regulatory Services- RM&rd V.Scalia Dhwlor Building Division Tom Perry,Balding Commissioner 200 Maas SU*A Hymnis.MA M601 - w"-town barnsmble.ma.ns office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section _ If YJ.s,�g.A Builder . I STEVE MERLESENA ,as Owner of the subject p ro perrf hereby aurhorize CO ad on my behalf, is alI matteis rr]ative to wont authorizEd by this bwlding perms application for. 74 RIDGEWOOD AVE HYANNIS, MA (M&ss of Jobs '`'`Pool fences and alarms are the responsibility of the applicant.Pcmis are not to be Bled or utilized before fence is installed and Al final MS.P coons are performed and.accepted. S4MU4 of Owner. Signature of Applicant ��eve t t h Scaa Print Name Priac Name Date _ Q:FowKsow��s�ormoois - r The Commonwealth of Massachusetts Department of lndustrialAccidents s; 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia N orkers' Compensation Insurance Affidavit:Builders/Contractors/Electrlcians/Plumbers TO BE FILED WITH THE PERMITTING.AUTHORITY. Aimlicant In-Mation Please Print Le 'bl Name(Business/OrganizatiorAndividual): Cape Cod Insulation Address: 18 Reardon Circle - :City/State/Zip: South Yarmouth,MA 02664 Phone#: 508-775-1214 Are you an employer?Cbeck the appropriate box: Type of project(required): 1.1 i am a employer with 48 employees(full and/or part-time).* 7. ❑New construction 2.01 am a sole proprietor or partnership and have employees working for me in 8. Remodelitig any capacity.[No workers'comp,insurance required'.) 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.)t 9. Demolition 10 Building addition 4. I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or are sole, I I.❑Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions S. I am a general contractor and I have hired.the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurnncc.t b. 3 We aze a corporation and its officers have exercised then right of exemption per MGL a I4. ✓a Other Weatherization 152,110),and we have no employees,[No workers'comp.insurance required.) *Any applicant that cheeks box#1 must also fill out the section below showing their workars'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such,, tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'-compensation insurance for my employees. Below is the policy and Job site t, information. Insurance Company Name: Atlantic:Charter Policy#or Self-ins..Lie.4:.WCE00431902 Expiration Date; 06/30/2018 - ` Job Site Address: 7 �r�4 yf.'d�c� �t✓i/� .tlicJ/City/State/Zip: 'aZd 02 G Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the palm and penalties of perfury that the information provided above is true and correct Henry Cassidy i WW.rLWlY11YMMMw .-6M.�..,.�O..M . Sistlature: Date: Phone#: 508-775=1214 T Offlclal use only. Do not write in this area,to be completed by city or town officlal. City or Town: . PermittLicense# Issuing Authority(circle one): 1.Board of Health 2.Building.Department 3.City/Town Clerk 4.Electrical Inspector 54 Plumbing Inspector 6.Other _ Contact Person: 'Phone#: a I �1 CAPECOD-27 EDDUKE '4�oR�n CERTIFICATE OF LIABILITY INSURANCE FDAITE (30/6/ /2017Y) 017 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER C T CT Rogers&Gray Insurance Agency,Inc. PHONE o,Ext: ac No:877 816-2156 434 Rte 134 ( ) South Dennis,MA 02660 M I mall@rogersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company 24198 INSURED INSURER B:Safety Insurance Company 39454 Cape Cod Insulation,Inc. INSURER C:Endurance American Specialty Insurance Company 41718 18 Reardon Circle INSURER D:Atlantic Charter insurance Company 44326 South Yarmouth,MA 02664 - 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS-OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER 1MMIr LIMITS A •X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADE �OCCUR CBP8263063 04/01/2017 04/01/2018 DAMAGE TSESO RENTED occurrence) $ 100,000 MED EXP(Any one erson 5,000 PERSONAL&ADV INJURY 1,000,000 M'OTHER: L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE 2,000,000 POLICY jp& LOC PRODUCTS-COMP/OPAGG 2,000,000 B AUTOMOBILE LIABILITY o COMBINED SINGLE LIMIT 1,000,000 ANY AUTO 6232707 COM 02 04/01/2017 04/01/2018 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY BODILY INJURY Per accident X_ AUTOS ONLY X AUTOS ONLY PRer ccltlent AMAGE $ C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS CLAIMS-MADE 635002 AGGREGATE X 2,000,000 DIED RETENTION$ D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY R/O WCE00431902 06/30/2017 06/30/2018 ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT 1,000,000 MandaFFICERIMEMg EXCLUDED? ❑N NIA 1,000,000 tory In NH E.L.DISEASE-EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) Workers Compensation Includes Officers or Proprietors. ' Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Information Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016103) _ ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Masea�husetts Department of PWIC safety Board 0 Building Regulations and standards Lloensei 08•1009s8 Construction Supervisor • `1,,,1•,i I� JJF t f�, HENRY E CASSIDY; 8 SHED ROW WEST YARMOUjH ".PP, 1aol a 1 1 J 1111 1 1 Expiration: Co missloner 11/1 a 11 017 I t Office of Consumer Affairs and Buslriess Regulation 10 Park Plaza - SUite 5170 Boston, Ma ' t;.�jLU efts 02116 Home improveme.::„�CaSt actor Registration Type: Corporation Cape Cod Insulation In-0 Registration: 153567 IU 18 Reard� Circle "' a-d.J'` 'w Expiration; 12/14/2018 So G Yarm outh, v uth MA 4 2 ,.�0 6 6 y t rl T Update Address and return card, Mark reason ivr change, �e�o,rvnco�ctvarr�t/oyBG3�G��wdvr_......... ,..,,.................. _......,. ,(„7•.�1dr,:��t�fi,.j,'�..11;•t'n�?.�r;n�—!�a,..n;plcym•ant_�'1.1.r�.s!.^�'�i... v/crwet�•.,... Cffloe of Consumer Affairs&Business Regulstlon I HOME IMPROVEMENT CONTRAOTOR Registration valid for Individual use only 10; -.t Corporation before the expiration date, If foun urn tot „•. I1s'yifv Ex Iration Offloe of Consumer Aff and el as Re uletlon ", � 12/14/2018 10 Park Plaza. a t31T0 g Cape Cod Inswii Boston,M 11 Henry Cassldy' , 1``�'I,,.. 1 18 Reardon Cirv� `V �, �''� ,¢ So,Yarmouth,M ' ?' �� Underseo-- r— e�'" t al hout sl atu ` 10APECOD-27 CLEDDU E CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) `0 613 0/2 01 7 fuATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS �;r1i"E DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE.A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED 1SENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. - ,okRTANT: If the certificate holder is an ADDITIONAL INSURED,the,policy(les)must have ADDITIONAL INSURED provisions or be endorsed. /-tf 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 endorsements. PRODUCER CNRA TACT Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 A/C,No Ext: Arc,Na:(877)816-2156 South Dennis,MA 02660 - AppA .'mail@rdgersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company 24198 INSURED INSURERS:Safety Insurance Company 39454 Cape Cod Insulation,Inc. INSURER C,Endurance American Specialty Insurance Company 41718 18 Reardon Circle INSURER D:Atlantic Charter Insurance Company 44326 South Yarmouth,MA 02664 . - INSURER E INSURER F: t - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED.TO THE INSURED NAMED ABOVE FORT HE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY-HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR- POLICY NUMBER - POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000.000 CLAIMS-MADE 000CUR CBP8263063 04101/2017 04/01/2018 DAMAGETORENTED 100,000 MED EXP(Any one person). $ 5,000 . PERSONAL&ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:` GENERAL AGGREGATE 2,000,000 X POLICY j�T .�LOC PRODUCTS-COMP/OPAGG 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 fE,ANY AUTO. ,6232707 COM 02 04101/2017 04/01/2018 BODILY INJURY Perperson) $ OWNED SCHEDULED, AIURTEO$ONLY X AUTOS BODILY BODILY INJURY Per accident X AUTOS ONLY X AUTOS ONLY P.�eccRdent AMAGE $ C UMBRELLA LIAR " X OCCUR EACH OCCURRENCE 2-0001000 X EXCESS LIAB CLAIMS-MADE EXCl0006635002 04/01/2017 04/01/2018 AGGREGATE' 2,000,000' DED RETENTION$ D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' PARTNER/IABILITY R/O WCE00431902 0613012017 06/30/2018 STATUTE ER ANY PROPRIETOR/PARTNER/FJ(ECUTIVE YIN E.L.EACH ACCIDENT 1,000,000 QFFICE�i/MEMBF_R EXCLUDED? N I A - - ;1,000,000 . DUI as,descr In ) E.L.DISEASE-EA EMPLOYE If yyes,describe under _ DESCRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICY LIMIT 11000,000 DESCRIPTION OF OPERATIONS/.LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more apace Is required),.' Workers Compensation Includes Officers or Proprietors;+ ' Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Information Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. " AUTHORIZED REPRESENTATIVE ------------ ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD'name and logo are registered marks of ACORD , l Town of Barnsta *Permit# ® Tres 6 months from issue date Regulatory Smic Fee 6 yUAM . , Richard V..Scali,Director ' Building Divistwo,�q� j 2 Paul Roma,Building Commissio$�� .. ,01. 200 Main Street,Hyannis,MA 02601 ��p www.town bamstable.ma us - Office: 508-862-4038 %px: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprinf Map/parcel Number Property dress , esidential Value of Work$' � (�p �� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address r ili4 n0 / 6 Contractor's Name IL OC' L c Q I/ Telephone Numb b Home Improvement Contractor License#(if applicable)' ��Dom_ Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I a sole proprietor w ❑ am the Homeowner I have Worker's Compensation Insurance- Insurance Company Name Workman's Comp.Policy# CJ Copy of Insurance Compliance Certificate must accompany each permit. _ Permit Reques eck box) e-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 ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *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 requ ed. SIGNA Q:\wPFILES\FORMS%uilding permit forms%%PRESS.doc 01/25/17 • A -7 � Wog ?lie Commonwealth of Massadiuseft VJDepartment of 1nduslrial Acdd=& Office oflmwstigadons 600 Washington Street Boston,CIA 02111 wrwv.masagovldia Workers' Compensation Insurance Affidavits Builders/Contractars/EIectdcians/Plumbers Applicantlufarmation Please Print Legibly Name Si0zssK o ff: Address: 6 v t CityfS Pll(= Are Ku an employer?Checkthe appropriate box: ' Type of project(required): I. I am a employes vd& 4 4. ❑I am a general contrackw and I 6. ❑Nevi construction employees(furl an&or part-fime)_* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling slip and have no employees. . These sub-contractors have 8.-❑Demolition wading for me in any capacity. employees and have wodcers'. 9. ❑Building addition [No widrkers,comp.insurance Comp. required_] 5. ❑ We are a corporation and its 10❑Electrical repairs or additions 3.El am a homeowner doing all work officers haveexercised their 1L Plumbin airs or additions myself [No vror�'omF- right.of a w4don per MGL 12 insurance required.]Y c.152.§I(4�andwe have no �� employees.(No wodoess' 13.❑Other conp-msmwce .) •Azzya" ca katchecloboagluastdwMout the swdonbelaw showing dwkwalen:campeasatianpolicyinEatmation. ?Hamemvaers who submit ibis affidavit infficating they are doing all work and Hum Ike outside commcmrsnmst mbmit a rem afdavit indicanog such. rConuvcl. that check this boot must attached su.additianal sheet showing the nee of ibe sub-conftw om and stile whether m not those emities have employees.7ftbeaob-contmcrmhace employees,theynn,rpmvidetheir warkeW-c mp.policynumber. .Tam au erlrpko yr tliat is prauidrng workers'cairgm tsagen f u7srance for my emplajwaL Berow is thepoficy and job site information. Insurance Company AFame' t—A K Policy 9 or Self-ins.Lic.* ' ,2—gi \ Expiration Date: Job Site Add. t.V v City/Statel7.tp: Attach a copy of the workers'coampen tioa policy declaration page(showing the policy rum er and expiration date). Fail=to secure cov enge 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 andfor one-year in4nisonmeat as well as civil penalties.in the form of a STOP WORK ORDER and a fine of up to$250.00 ajdaylrgMift the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations flee DIA fb4insurance — ,do leer certi a andpeiiab?ies ofperjury ihatdie it fonnaiffmi provided bm�a' bzre atsd correcit Si ate. one _ Ojo al use only. Do not write in this area,to be completed by city or town officiat City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CityOTown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone 9: 6 Information and Instructions Mzss r_ melts CTeteral Laws chapt r 152 requires all employers to provide worceas'compensation for their employees. pursumatto this sty,an err pinyw is defined as."—every Person in the service of another under any contract of hire, express or inplied,oral or wrhmf An errpkyer is defined as"an individual,pmtamJ*,association,corporation or other legal entity,or any two or more of the foregoing engaged ia a joint entaprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,parhaersbip,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 - dwelImg 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." MOL 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 burTdmgs iia the commonwealth for any applicant who has not produced acceptable evidence of compliance m with the surauce.coverage required-" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any ofits political subdivisions shall enter into any contract for the pP an ce ofpublic worc until acceptable evidence of compliance with the fimu lce. r erts of this chapter have been presented in the contacting avdhon ty" Applicants Please fill out the Workers,compensation affidavit completely,by checking the boxes that apply to your sitnation and,if necessary,supply sob-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than tine members or partners,are not requked to cagy 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 Deparlment.ofIndustrial Accidents for confirmation of msurance coverage. Also be sure to sign and date the affidavit The affidavit should be retxmned to the city or town that the application for the permit or license is being requested,not the Department of Turin ctrid 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-insarance license number on the appropriate lime. City or Town Officials Please be sure that the affidavit is complete and pried.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 pemtit/licemo nwnber which will be used as a reference number. In addition,an applicant that must submit multiple pen ait/hcense applications in any given.year,need only submit one affidavit indicating current p olicy �infoation Cif 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 penn#3 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 venue (Le. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would Ih1ce to thank you in advance for your cooperation and should you have any questions, please do not hesitate,to give us a caIL The DeparimenYs address,telephone and fax number. 'T134a th-of Massachuw-- k Department cif l iffint al AocZenta office of XnvP otio= 6Q�Washington t 13��14fA f1�1.1F Tt,-1.A 617- -49W cxt406 or 1-977-MAS AFF, Fax#617-727-774 Revised 4-24-07 ma �c�f�ia Town of Barnstable Regulatory Services ' °. ! Richard V.Scali,Director Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maus Office: 508-862-4038. Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, C �f dq ,as Owner of the subject property ' hereby authorize "f� �'1 101.COCt` to act on mp behalf in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the`applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature-of Owner Signature Applicant �Q-'t/S?1"�sc,J ^ b Print Name Print Name �? Date Q:FORMS:OWNERPERMISSIONPWLS Town of Barnstable Regulatory Services p1: Richard V.Scali,Director Building Division n.ux8r_1 a = Paul Roma,Building Commissioner MAM 1"9. � 200 Main Street, Hyannis,MA 02601 www.towmbarnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 HOME_OWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cityhown 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. 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 al of Building Official Approval u g 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 EREEmirr ON 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 shall-act as supervisor." r hire to do such work,that such Homeowner engages a person(s)for k, P Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor see Appendix Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often Q� � g ( PP 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. i Q:\WPFILES\FORMS\building permit 1brms\EXPRESS.doc 0620/16 f a/(.,1 CCIdJnC1111jet!s Board of Building Regulations.and Standards Office of Consumer Affairs&Business Regulation License'CSSL-099828 HOME IMPROVEMENT CONTRACTOR :onstruction -4ervisor Specialty 1 Registration 165907 Type: f Expiration .4/67201,8 Private Corporation TED L HITCHCOCK TL HITCHCOCK CONSTRUC ON"SERVICE INC. 55 LISA LANE ' WEST BARNSTABLE MA.62668 THEODORE HfTCHCOGK 55 LISA LANE WEST BARSTABLE MA-02668 Undersecretary ' Expiration: 1 Commissioner 06/0112018 —` License or registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 0211 Not valid without signature 9 Page 1 of 1 2017-04-1012:58:25 EDT 18665443184 From:Anne Sanzo DATE IMMMONYYY) CERTIFICATE F LIABILITY INSURANCE 04110/2017" THIS.CERTIFICATE IS ISSUED AS.A MATTER'OF lNFokmAT- ION-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 CI FZTIFICATE Of. INSURANCE "DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,ANO T14E-CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is-an ADDITIONAL INSURED,the poiicy(les)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 endorsements. PRODUCER CONTACT NAME HUB INTERNATIONAL NE LLC PHONE p- - lc Na: 265 ORLEANS ROAD E-MAIL .ADD ESS• N.CHATHAM MA 02650 INSURER(S)AFFORDING COVERAGE _ -NMC a _ INSURERA: TRAVELERS INSURED INSURER B: T L HITCHCOCK CONSTRUCTION INSURER C: _ 30 SCORTON HILL ROAD INSURER D: ~ WEST BARNSTABLE MA 02668 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 CONDETION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED,BY THE POLICIES OESCRIBED HEREIN IS SUBJEGT TO ALL THE TERMS, . EXCLUSIONS.AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLrCY NUNIBER MMIDD MIDDl LIMITS - GENERAL LIABILITY EACH OCCURRCNCE $ COMMERCIAL GENERAL LIABILITY DAMAGE REoNcc hence $ CLAIMS-MADE FJ OCCUR _MED EXP(Any one parson) $ PERSONAL&ADV INJURY $ .. GENERAL AGGREGATE- $ GEN'L AGGREGATE.LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $" POLICY 'PRO. L C $ AUTOMOBILE LIA...GIWTY OMBINEU SINGLE LIMIT" ANY AUTO BODILY INJURY(Pof peftn) $ ALL OWNED SCHEDULED "' BODILY INJURY(Per=idenl) $ AUTOS NOUTOS N•OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Pf socident $ UMBRELLA.LlAS OCCUR .. .. r EACH OCCURRENCE $ .. EXCESS LIAS CLAIMS-MADE AGGREGATE $ DEO RETENT1ONE_.. _ ..._ WORKERS COMPENSATION WC STAT+U- U rH- AND EMPLOYERS'LIABILITY FQRY LIMITS 1000000 ANY PROPRIFTORlPARTNER/EY.ECUTI4E• YIN N E.L.EACH ACCIDENT $ OFFICEWMEMBEREXCLUDED?.• •.,�N,1A 7PJUB2E101644 03[2g12017 03126/2.018 .1000000 (Myyaiadalo-ryinNH) E,LDISEASE-EAEMPLOYE $ er DESCRPTI{7NOFOPERATIONgbelaw E.L.WSEAiE- OLICYLIMIT `.$'_' '')1000000 I . .. •" DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORG 101,AddtUonal Romaft Sphodolo,If more sp,kco is required) CERTIFICATE Hot.neR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES l3E'CANCELLED BEFORE TOWN OF-BARMSTABLE THE EXPIRATION DATE 'THEREOF; NOTICE WILL "BE DELIVERED IN 2dQ.MAEN'STREET ACCORDARGE WITH-ft[1dfl49r rP*Ww-�ng113t1C)iUI,"r -"yANNIS"MA 026Q! "AUTktOftIXE O';Rk=PR�SENiI�IVE ACORD 25(2010/05) C11908 2010 ACORD CORPORATION. All rights reserved. The ACORD name and toga are registered marks of ACORD r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION COMMON PERMIT FROM THE r Map Z Parcel 2z ENGDMNG DIVISION MR T¢ermit# 3 CONSTRUCTION. Health Division G&SS7 /-q—1.3-0a Z) Date Issued 2 (o/0 5 Ewe 0 Conservation Division Application Fee Aff Tax Collector :a o c) Q © k - KI L r a ) 1r 10A Permit Fee l Treasurer s Planning Dept. Y-1 Date Definitive Plan Approved by Planning Board --- Historic-OKH Preservation/Hyannis /� i Project Street Address «74 � (�(� ,,Q �I O� Vxuz Village AhA[A{ � r- Owner IAPce, Address _1CA 1' i kA Telephone Permit RequestE<44a, S 7 ak G - v (off proposed 2nd floor: existin (o'?� Square feet: 1 st floor: existing p p g proposed Total new Zoning District Flood Plain Groundwater Overlay i%Project Valuation '� _ �� Construction Type Lot Size 0 X 1 C'M Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Existing of Age Structure l C1`L- g g // 2 Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes Flo Basement Type: MFull 0 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 1Z new Half:existing new Number of Bedrooms: existing a new Total Room Count(not including baths): existing tp new First Floor Room Count 3 Heat Type and Fuel: N Gas ❑Oil 0 Electric ❑Other ,Central Air: ❑Yes Ml�o Fireplaces: Existing New Existing wood/coal stove: ❑Yes M o Detached garage:Odexisting ❑new size Pool: 0 existing ❑new size Barn:0 existing 0 new size Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name .� .d�- �- 1(� I(2- Telephone Number Address�(- L1 J, r� 1,'1, License# C E n 7 C141110 IM9 0 24 27 Home Improvement Contractor# /o C14 3� Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO � I SIGNATURE i DATE Z FOR OFFICIAL USE ONLY � t PERMIT NO. DATE ISSUED ' MAP/PARCEL NO. •- , ADDRESS VILLAGE f OWNER _ 1 r DATE OF INSPECTION; . FOUNDATION I RAMS-? INMUTION c„C7 4 FIREPLACE ELECTRICAL: ROUGH ` FINAL " PLUMBING: ROUGH L FINAL; GAS: ROUGH FINAL- • F FINAL BUILDING 6/:�iN'l DATE CLOSED OUT ASSOCIATION PLAN NO. ' Y i The Commonwealth of Massachusetts Department of Industrial Accidents Olficc ol/nYestigatives -_ - --_: 600 Washington Street v Boston,Mass. 02111 Workers' Com ensation Insurance davit �//G/////��id(��i��i.��j�jj//j�jj��/ name: hone# ❑ I am a homeowner pe rming all work myself. ( am a sole r rietor and have no one workin in ca achy mP an rs ///I/ 1%/%/%% this ;:: rovidin g� ::. }:%;;;::;::::.;:>:::2:.;::.;}}:;.}:.;?:;;:.:}:.:.,.""^"":",'::::.............................. ........, ..... ... n .tom .....:.......:;::::.: ;•;::.::::::,::.;;:•?:<.:>:s::?:>��•�:s<:;:}:� hr acLUess:: . ........ •."o Yt' i' gj"<> i ?+<[ %'?ii<; "cf"apt ?< :`.::...,. > " }h n ,:::.;,::•:.::•:::::::. •.•�'.CD:i�i;iizi?%:'•`i�i��;;sz:%'<iii?`:E:;i:2'S�%?;?? �i�ii'•��'ii:?i�i: ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have olices: the .......... ......... ......... ..................::::::::::::.:ati ::.... .:. ..:?•:.::.::::.^:::.�.,.:.,.,... <« .tomIn ors ki :a tit• .:::::::..:.,:.:. ...... ..... ... .. ... .... ... .... ... .....:.v:::::n,v:::..W:•:n•:::;•: "•nt .• :,.{{::•i;1:•:'�:Ciu�:::L:ttL':•: nS:i• ii:y'ii�i::;•'.i')i$:i::j}i:;:' iiiiii:>.•i}:•:•i}:!4Y.:•:rii:ii'iri::i;:';{S�i:!�ii'riii:iii:;�:}��i:�S�:+i: is{y}!>ii:•:C>f{+:::<::::!�;ii?::;:•,:jib:}?,{l:::i:4?;::j {ij::n:+•,•�'i:[ .n...... ....................::i}::::-.v•.v:,::.}:4}:•?}::{{?}i'{::•.:•i?-:i•.?. h:•{::�:••v:4:}:}i}:?:..... ryi::ii:v'.v..':,�{';•;L}'::.:+'•}:•}:{•i {•?r.?:}::f<:' %;'<�:::::?: ?<:':i •': ::;:�,••;•:>:�' ?:%>;:::%ci:`::y{£ :i;:''�%:�ir:: j5:::':� ::v�:?`-Sir`:;:+<':'2::�<�%%;iSi��2 ::;:;i:. %::Sr�?:% n >g c `ott ........: .. ....................................... .... ..:w::......,:.................. ;... ... ... ... ...................................::::::.....:.....ii}}i?:L;•}i}ii:�}}}}:;':?}?i??}??i}}}:?}?:}.ii:::i:vn.::w:4;S•}:•.{J'•.vy}:n•.;:::{::::{.;{:.:... :x ...:....... of gaffme to aecnre coverage a,req�red raider Section 25A otMGL 152 can lead to the imposition of crhitinal pea day ga a line- to derst.00 and/or one years'impris ontnent as weII a!duff penalttea in the form of a STOP WORK ORDER aad a 8ne of S100.00 a day against me. I m►deratand that a copy of this statement may be totxsrded to the Office of Investigation of the DIA for coverage verification. I do hereby certify he a_njQ4.?enalties of perjury that the information provided above is true and correct Date L/ L�/t� - - Signature ' Phone# Print name official use only do not write in this area to be completed by city or town official permit/licene# ❑Bing Department city or town: ❑Licensing Board ❑selectmen's Office ❑checkif immediate response i'required []Health Department contact person: phone#; ❑Other (Jeyyed 9195 PJ/a Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied,oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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 permitllicense number which will be used as a reference numlaer. The affidavits may be rehimedtn the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any.questions. please do not hesitate to give us a CO. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents amce of layestlgations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 #74 Rid-gewood Kitchen Finish sink cabinet Mastic on wall over stove area o4heetrock and insulation under window ykeplace panels in ceiling Floor-sand and paint? Plumbing-hook up sink fixtures - cap old drain Electric-replace outlets with code approved - install overhead light Bathroom Plumbing-check shower Electric-replace outlets Floor-patch linoleum Living room Windows glaze and paint Electric-replace outlets and add as required Second floor Bathroom Plumbing -check shower Electric-install fan / - replace outlets -t" Back bedroom-sheetrock ceiling -paint Front left bedroom-fix side window sill Front right bedroom - install window trim ✓ - patch walls and paint Cellar ,/Remove all debris-rugs,furniture,etc. ,/Cap off plumbing Outside ✓Power wash and paint Need electrician to inspect and pull permit Need plumber to inspect and pull.permit �fTHE F, Town of Barnstable Regulatory Services * saxxsTasLE, " Thomas F.Geiler,Director 9�A 116A3899. $ lFD MPS Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: f !2i Estimated Cost Address of Work: —7 L4 ( box U ALE Owner's Name: yJ G✓Vt I;� iA� Q1'� Date of Application: sil 0 /b Z I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law Wb Under$1,000 uilding not owner-occupied El Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owne Date tontractoi Name Registration No. OR Date Owner's Name Q:forms:homeaffidav Town of Barnstable �OFTHE Tp� Regulatory Services BAMS ABLE, v MASS. g Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Check One: [—]Shed ❑Deck ❑Pool ❑Porch ❑Gazebo ❑Detached Garage FOR ALL APPLICATIONS: ❑Determine map and parcel number and enter it on application. (This information maybe obtained from the Engineering or Building Dept.) ❑Completed Building Permit Application Approval/sign-offs are required and can be obtained at 200 Main Street: ❑Historic District Commission ❑Old King's Highway Historic District (North of Route 6) ❑Hyannis Main St. Waterfront Historic District (see map for boundaries) ❑Historic Preservation(if applicable) ❑Health Department ❑Conservation Commission ❑Tax Collector ❑Treasurer ❑Homeowner License Exemption Form(if homeowner is acting as general contractor/builder for project) or Copy of Construction Supervisor's License must be submitted (except for in-ground pools) ❑Worker's Compensation Insurance Affidavit must be submitted. ❑Home Improvement Contractor Affidavit must be submitted (residential only). []Copy of Home Improvement Contractor's License (residential only if applicable) ❑Permit fee. SHEDS/DECKS/OPEN PORCHES/GAZEBOS/DETACHED GARAGES: ❑Plot Plan or mortgage survey required to verify zoning compliance. Placement of proposed structure must be sketched in and the distance from property lines indicated. The location of the septic system should also be shown. ❑Two (2) sets of plans (8 1/2"x 11" or 8 1/2"x 14) showing cross section and framing schedule. ❑Prefab sheds require factory brochures &specifications. ❑Prefab sheds require a copy of the Home Improvement Specialist's License unless the homeowner is applying for the permit in their own name._ POOLS(250 sq. ft.and over or 2' deep or deeper require a building permit) ❑Plot Plan or mortgage survey showing the proposed location of pool and the distance from property lines. Plans must also show location of backwash pits if applicable. ❑ Construction Drawings or Factory Brochure & specifications. Q:forms:shed-deck r 790 CMR Appendix J Table J&Llb(continued) Prescriptive Packages for due and Two-Family Raid ential Buildings Heated with Fowl Fuels MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Besemcut Slab Heating/Cooling Aria'('/o) U-value= R-value' R-value R value° Wall Perimeta Equipment Efficiency' Pie R value' R value' 5701 to 6500 Heating Degree Drys' Q 12% 0.40 38 13 19 10 6 Notmal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 85 AFUE T 15% 0.36 38 13 25 N/A N/A Normal U 15% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25 NIA N/A 85 AFUE W 15% 0.52 30 19 19 10 6 85 AFUE X 19% 0.32 38 13 25 N/A N/A Normal Y 18% 0.42 38 19 25 N/A N/A Normal Z 18% 0.42 38 13 19 10 6 90AFUE' AA 18% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: r q-forms-f980303a 780 CMR Appendix J Footnotes to Table J5.2.1b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded from a building design with 300 ft of glazing area. 'After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling.R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the,ventilated portion of the roof. 'Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry, log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned baements must be included with the other glazing. Basement doors must meet the door U-value requirement &scribed in Note b. 7 The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). r 43 i j�wj---.• __:_ �._.. ...�_,pp. .._-.�,..w.......,....�_.�.._..__..:.....�,.,u.: Wiz `; — `\` fie i�anainw7uaea� o��/�,cusac�ucaelta \ BOARD OF BUILDIN REGULATIONS License: CONSTRUCTION SUPERVISOR NumbereSCS. 016187 Birthdate: 07/16/1940 � r tUpires 07/16l2003 Tr.no: 216 _ 0 Restricted: 00 ALEXANDER C BLAIR PO BOX 22 ( ,� - CUMMAQUID, MA 02637. Administrator owl ' �E IMPROVEflENi CON C O.v f atiolr 0038 I( Expiration. Ob/08/2Q02`�J rA ! J Type: dual Lr RLE1( - ER L BLRIR �-- A under, Blair.— r � �R.9MINIS7RATOR r°, RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSBEET l NEW LIVING SPACE square feet x$96/sq.foot= x .0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE f square feet x$64/sq.foot= 6W x .0031= 2- 5 plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x .0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee - T)4& xo6 � 4. 9 Berl-( D�� C. e C4- S11%F oErEcT® eARNSTAeI -zo •. G D r IC 71- 1. � r i •; " .: 4 U �!1 U U C ;•J C ; I'oLt,ImIrJr1'. "0'� , Q � J { 09406 ;,"r_4bCt;- -- tQ L A R` iel'vY i --�.,,� `_ _ C C� � �� w! Jim F w �y�TMi 6•� i LO uO s. *. ca i N r, cw s rr N O Z �i ��► , ,�. � !�- �,:� ' ��- �'t-"E � � ,�w k I wk��r�y� � � �!��rNFA7 i' wt �o � "'sl�luhl�l�.tr -- t',d ... ,r•�!t+. wNl'1Mr tu�F .,i�/'x it�ert.�, �70�.�,� a$� �i�ak9 aw •�1 w.sh i .�y� '.e-+'r'+' i�F +t .. -- -M _ �` Tark � � � ... � ,..mow �:iAi.� J 'i � �M � - �.. - .� LX:_ -�- "' ...a ..�. qti �� .' ' y r�l YYY1Y.^Yl�i. � + r . � T ._ �w+�'_� r- � I.. � t �_ � � �-- h� -_ �� . , �-.- .. �_� � wr _,t,.� ,-�� } °ate ��". 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'�'t .�-1� 9 ��'r F.�_�',� t� ,mot M � V!'a� ,•.i��.� ` `� ".3i- LD co �L J CL [•J L'a7 + u� CJ y r� c� 's• u, o• `J � a �� u J Public Health Division Town of Barnstable June 11,2001 This is to reply to your letter received May 30 regarding violations listed for 74 Ridgewood Avenue, Hyannis. The white plastic drums are gone;returned to the commercial laundry from which they were taken by a tenant.The garage door has been fixed.The blue unregistered sedan has been removed by the former tenant who owned it.The carpeting,mattresses,used metals and wood have been taken to the dump.The chest freezer has been removed The refrigerators are being used as planters.The wooden windows are stored behind the garage and two rugs(rolled up)and a TV set are to be taken to the dump tomorrow. The engine hanging from the cedar tree has been removed and I am constantly in contact with the former tenant,Jean Paul Joseph (now at 85 Nautical Way,Hyannis,775-4985)to remove two other engines and . automotive debris piled in the driveway. He has assured me that they will be removed. Frank Gibson Harbor Point Road Cummaquid,MA 02637 508-362-3981 Frank W. Gibson P.O.Box 131,Cummaquid,MA 02637 phone: (508)362-3981 fax:(508)3624812 email:fgibson@capecod.net To the Building Commissioner Town of Barnstable ` Since our meeting two weeks ago regarding our properties on Ridgewood Avenue,Hyannis and your request for me to put in writing what I intend to do with the properties and to give you a time line, here is my answer. My first concern was to clean up the grounds around all three properties.This has been ongoing and this is the current status: 84 Ridgewood-There is one car in the front yard.It is owned by Jean Paul Joseph,a former tenant at 78 Ridgewood. I understand that the tenant in 84 was going to buy it but she changed her mind.Jean Paul has been asked to remove the car.There is a pick-up in the back yard.This is owned by the cousin of the former tenant in 84.He is to remove it this week.If he fails to do so, Max Cesard,the former tenant,will remove it. There are still three engines and four tires in the yards.These are to be removed by Jean Paul Joseph,who removed a lot of his automotive parts and the car that was in the garage at 74 Ridgewood last week.I hope to have all remaining debris in the yards removed by next week. I would like to make 74 Ridgewood Avenue habitable and will take out whatever permits are required to do this.To begin, I would like to replace the broken and missing siding.The windows to the living room will be glazed and put back.The plumbing will be checked for any broken connections and a new sink and counter installed in the kitchen.Both gas and electricity(a 220 line)were available for a kitchen range and oven. As to a time line,I guess it depends upon permits and inspections.I am anxious to proceed as rapidly as possible. , cl , V N('-ae,1 a-r" v.:e\nA C`Q-5 t--) L-e °FtNVE l° Town of Barnstable Regulatory Services vBA . Thomas F.Geiler,Director qjA i639. rE039 01 Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 FOLLOW-UP REPORT DATE: May 9,2001 INSPECTOR: Ralph Jones,Deputy Local Inspector 'k, LOCATION: 74 Ridgewood Avenue,Hyannis 78 Ridgewood Avenue,Hyannis 84 Ridgewood Avenue,Hyannis Property owner,Frank Gibson,met with the Building Commissioner on this date regarding the condition of the structures and yard on the above referenced properties. Mr. Gibson was given 14 days to arrive at some solution to bring these properties into compliance and submit same in letter form to the Building Division. g010502a , , � - � �- G� Ii ' , � } /� � -, �� - g - � i - - - - - -�C,P� - � � � � i , , _i�� .. -__ ____ � : ; i � , _.._._.....__� __.___.___________ _._..__. -- _ ___._�____ �,._ ____.T__� .� , i ; � ji �. ._ _ _. __�.-.. _ j i. _. �.-_...�_s.� ___�__._.�.._.�..a i � _. . i , x 5 !. I o h + BARNSTABLE, POLICE DEPARTMENT 1200 Phinney's Lane Hyannis,MA 02601 508-77"387 Your incident has been assigned.Ga5E A report will be available in the B.P.D.Records Division in 4 business days. Please bring this card with you Officer / Date: 05/02/2001 17:31 5087904167 BARNSTABLE PD PAGE 01 Barnstable Police Depa.rtment Page: 1 Call Nwnber Printed:" 05/02/2001 ror Date: 05/02/2001 •- Wednesday Call Number Time call Reason Action Priorit• Duplicate 01-11678 1103 Phone - B&E, RESIDENCE SERVICED 2 Call Taker: PTL. JENNIFER SONNABEND Location: (HYA) 74 RIDvFW00D AVE Principal Party: BARNSTABLE BUILDING INSPECT 508-862-4032 JONES, RALFH. L 4.00 SOUTH ST - H`.'ANNIS, MA 02601 Unit: 16 EVERETT, S Disp-110" Rrvd-1109 Clyd-111 3 Unit: 7 HOYE, D Disp-1106 A.rvd-1107 Clyd-1:113 Narrative: Building inspectoz states that someone may be li;rinq in residence, vacant. officer stated no one inside. Rear door had been kicked in and it appeared that people may be living in abandoned bu.ilcling. Requesting extra checks of residence that should be empty. Rear door was to he secured by the Barnstable Building Division. Bu?41ding owned by Frank Gibson of Cwrunaquid, t5C8) 362-3991. F TME ram, Town of Barnstable Regulatory Services 9BA ABLE'$ Thomas F.Geiler,Director QDp .s6gg �0 rFo 39 & Building'Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 INSPECTION REPORT DATE: May 2,2001 INSPECTOR: Ralph Jones,Deputy Local Inspector LOCATION: 74 Ridgewood Avenue,Hyannis MAP/PARCEL 328/220 PROPERTY OWNER: Diane R. Gibson 149 Harbor Point Road Cummaquid,MA 02637 This inspection was conducted at 9:40 a.m.,May 2,2001 in response to a complaint received by the Building Commissioner's Office. The rear door was broken open. I notified the Barnstable Police Department. Officer Hoye responded and entered the house. Ms Giangregorio and I entered the structure after Officer Hoye checked the interior. There were approximately 75 new paint cans in the kitchen. There were 2 bedrooms,living room and kitchen. The second floor had three bedrooms and a full bath. The bath had fecal matter in the toilet. There was n/owater or electricity in the structure. The bedrooms had signs of someone living there;cigarette butts, magazines,etc. The exterior had a one car garage,well rotted,with an unregistered vehicle inside. There were several plastic barrels in front of the garage marked"TOXIC". I notified the Health Department to investigate. Ed Barry,Health Agent,arrived and checked out the barrels. I asked him for a report on all of the buildings. Ms Giangregorio took several pictures with the digital camera. No house numbers were noted. g010502a � --- ,I � —_ --�I ,c„a�,� k� �4< . � ! i ��, yam"' i i �a Public Health Division Town of Barnstable June 11;2001 This is to reply to your letter received May 30 regarding violations listed for 74 Ridgewood Avenue, Hyannis. The white plastic drums are gone;returned to the commercial laundry from which they were taken by a tenant.The garage door has been fixed.The blue unregistered sedan has been removed by the former tenant who owned it.The carpeting,mattresses,used metals and wood have been taken to the dump.The chest freezer has been removed- The refrigerators are being used as planters.The wooden windows are stored behind the garage and two rugs(rolled up)and a TV set are to be taken to the dump tomorrow. The engine hanging from the cedar tree has been removed and I am constantly in contact with the former tenant,Jean Paul Joseph (now at 85 Nautical Way,Hyannis,7754985)to remove two other engines and automotive debris piled in the driveway. He has assured me that they will be removed. Frank Gibson Harbor Point Road Cummaquid,MA 02637 508-362-3981 r.- 3 f + F N THE FOLLOWING IS/ARE THE BEST. IMAGES FROM POOR, � QUALITY ORIGINALS) I mFC&E DATA �. �. • .-. m In of Barnstable F F 1 C 11 ;ulatory Services p Postage $ C o- nas F. Geiler, Director u"1 Certified Fee `a Postmark c Health Division Return Receipt Fee fTl (Endorsement Required) Here r .-R O Restricted Delivery Fee mas McKean, Director p (Endorsement Required) p Total Postage&Fees $ ( Street, Hyannis, MA 02601 LTo _ _ �_-_-__ Fax: 508-790-6304 pp - - t Cummaquid MA. 02637 . NOTICE TO ABATE VIOLATIONS OF 105`-CMR 410.00 STATE SANITARY CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE ARTICLE 51 The property owned by you located at 74 Ridgewood Ave,Hyannis was inspected on May 2, 2001, by Edward F. Barry, Health Inspector for the Town of Barnstable because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code 11,Minimum Standards of Fitness for Human Habitation were observed: 410-602A: AT THE REAR OF THE HOUSE THERE IS TWELVE 55 GAL. WHITE PLASTIC DRUMS. THESE DRUMS WERE APPARENTLY FROM A COMMERCIAL LANDRY OR'-. DRY CLEANING ESTABLISHMENT. ("VALID II CONC. FABRIC SOFTENER AND CONCLUDE PLUS LIQUID SOUR H3PO4). ONE GARAGE DOOR BROKEN,BLUE UNREGISTERED SEDAN, OLD ENGINE, OLD CARPETING, OLD BEDDING; OLD .FURNITURE.ALSO, AT THE REAR OF THE GARAGE THERE ARE PILES OF OLD CARPETING, OLD MATTRESSES, OLD WOODEN WINDOW FRAMES. THREE OLD REFRIGERATORS USED AS PLANTERS. ONE OLD RUSTED CHEST FREEZER WITH LID, FOUR PIECES-OF OLD FURNITURE, ONE WHITE WATER CLOSET. AT LEFT SIDE OF HOUSE: MULTIPLE SCRAPS OF OLD USED WOOD, USED RUGS, USED APPLIANCE DOORS,USED METALS,USED BLACK METAL FRAME OF SOFA. BACK OF HOUSE: OLD CAR ENGINE HANGING FROM A CEDAR TREE. OLD BROWN ONE DRAW CABINET,PILE OF USED ALUMINUM STRIPS VARIOUS LIGHTS;MISC-LENGTHS OF OLD USED WOOD, USED MATTRESS COVERED WITH BLUE TARP. RIGHT SIDE OF HOUSE: PILE OF OLD USED STRAPPING STORED ON THE GROUND AT RIGHT SIDE OF DWELLING. gr You are directed to correct the violation above within (10) ten days of receipt of this notice by removing all of the above listed debris. You may request a hearing if written petition requesting-same is received by the Board of Health .-within seven (7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE BOARD OF HEALTH Aasc ean. Director of Public Health s� i y i, f , s 3 ' i� . . ■ mplete items 1,2,and 3.Also complete A. Received by(Please Pnnt Clearly) B. D of D livery fin if Restricted Delivery is desired. b d ! s int your name and address on the reverse C ature so that we can return the card to you. �� `�� is ❑Agent ■ Attach this card to the back of the mailpiece, or on the front if space permits. ❑Addressee D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No vU O rl 3. Service Type t ❑Cortifie Mail ❑ 5prgss Mail r Registered ® Return/Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑ Yes I 2. Article Number.(Copy from sere/ce label PS Form.3811,July 1999 Domestic Return Receipt 102595.00-M-0952 Giangregorio Robin From: McKean Thomas t To: Giangregoria Robin cc: --_Barry Ed Subject: RE: Ridgewod Ave., Hyannis Date: Wednesday, May 30, 2001 8:37AM A certified order letter was sent to the owner of the property last week. At this time, we are awaiting the green receipt card. From: Giangregorio Robin .To: McKean Thomas Subject: Ridgewod.Ave., Hyannis Date: Wednesday, May 30, 2001 8:17AM , Before I left on vacation, Ralph Jones, myself and Mr. Barry met at Ridgewood Ave regarding some possible violations crossing the jurisdictions of both Building and Health. I would like to obtain a copy of the reports, communications and ultimate results,(if any)filed in your office for our street file. This addition information will assist us in keeping a more complete profile of properties and corresponding complaints. Your cooperation is always appreciated. Thank-you. Page 1 Wei • a o ,� 's�,f .�. \rtc r„�A•1.or2D 9�/s ✓� C:l.�s,,,-Ar GrIZ ��,s�nJ co- Town of Barnstable Regulatory Services r r vBAMSTABMMASS. $r Thomas F.Geiler,Director �A .i63939 ♦0 RFD Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 FOLLOW-UP REPORT DATE: May 9,2001 INSPECTOR: Ralph Jones,Deputy Local Inspectoro, LOCATION: 74 Ridgewood Avenue,Hyannis 78 Ridgewood Avenue,Hyannis 84 Ridgewood Avenue,Hyannis Property owner,Frank Gibson,met with the Building Commissioner on this date regarding the condition of the structures and yard on the above referenced properties. Mr.Gibson was given 14 days to arrive at some solution to bring these properties into compliance and submit same in letter form to the Building Division. I g010502a i Town of Barnstable Building Department Complaint/Inquiry Report Date: 2^2 e-411 Rec'd by: Assessor's No.:,AA Complaint Name: Location Address: �y /C�G�2dt�DllC��dGn/uG . �/�, i✓�t//J M/P Originator Name: /�a�i✓/S ii� ��✓,�,r7�c ;�i�,� ii✓�-Gh�7 Street: Village: N I-r State:l7�.ss Telephone: D/E Complaint Description: Inquiry 0 ' Description: F " For Office Use Only Inspector's Action/Comments Inspector: - Follow up l'� v ��cfGva��/✓07 G/ic /��/eu��C�>Y9�/ Action C' CZ / ol Additional Info. Attached Copy Distribution: White-Department File Yellow-Inspector Pink-Inspector(Return to Office Manager) ' .�.1✓' w.�.•r �.�a.� �Y w /' i . v ��i� A ! `.ice ��• � .•. /, � � - � ' -- � _ � � `.!.. ,' I / r J._ 1 I �i 1 � 1 rams Will! -0 i A mjk - MAWA .�