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HomeMy WebLinkAbout0084 RIDGEWOOD AVENUE etc C�C4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application Health Division Date Issued-7-l 1 0 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis p 4�,,� Project Street Address Pf- X<,Z9 �,J�� ,Q✓ Village I d Owner e �, ��� �t 2/ s d-.e��J /��' y&a,(Address Telephone�CVf - !g'r i Permit Request lAesy,411 G "Z9 Z CIA 1. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1 r © Construction Type /Li&:�/ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 20"" Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes .ErNo On Old King's Highway: ❑Yes -a"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: U existing ❑ new size_ Attached garage: ❑ existing 0 new size —Shed: ❑ existing ❑ new size _ Other: ��� Zoning Board of Appeals Authorization ❑ JIfC Appeal # Recorded 0 ?Q'� Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - - - Name _:u 417/sQ,e/ Telephone Number u< a8 :Z7 Address /9' License # Home Improvement Contractor# Email &j�Ja&r ilk ,Z-r/� ® � Worker's Compensation # _,ez ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED ` 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. s The Commonwealth of Massachusetts Department of Industrial Accidents s I Congress Street,.Sulte 100. Boston,MA 02114-2017 www mass.gov/dia . Workers' Compensation Insurance Affidavit:Builders/Contractors/Electrlcians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY:. Aimlicaut f rmatiM Please Print LeLvibly Name (Business/Organization/Individual): Cape Cod Insulation Address: 18 Reardon Circle City/State/Zip: South Yarmouth,MA 02664 , Phone#: 508-775-1214 Are you an employer?Check the appropriate box: Type of project(required): i 01 am a employer with 48 employees(full and/or part-time),* 7. ❑New construction In I am a sole proprietoror partnership and have no employees working for me in 8. Remodeling 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'compawdon insurance or are sole ` 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or-additions S.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs nest sub-contractors have employees and have workers'comp,insurence.t Other Weatherization✓[� 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. , 152,§1(4).and we have no employees.[No workers'comp.insurance required.] •Any applicant that cheeks boot#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 3Contractors that cluck 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 subcontractors have employees,they must provide their worken'comp,policy number, I am an employer that is providingg workers'compensation insurance for my,employees. Below is the policy and job site information, Insurance Company Name: Atlantic Charter Policy.#or Self--ins.Lic.M WCE00431902 Expiration Date: 06/30/2018 Job Site Address: �oe,-�J City/State/Zip: f� 1 Attach a copy of the workers' compensation policy declaration page(showing the policy num er 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$250.00 a day against the violator,A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification: I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Hen Cassid Signature: ry y �. ..�:�.� Date: _ Phone#: 508-775-1214 Official use only. Do not write in this area,to be completed by city or town,ofllclal. City or Town: PermitlLicense# issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5►Plumbing Inspector 6.Other Contact Person: Phone#: i Massa7,husetts Department of Pubilo Safety Board of Building Regulations and Standards Lloense; 09.1009$a Construction Supervl,sor t•t t� t��, x.;;, HENRY E CASSIDY;�` 8$HBO ROW WEST YARMOUJH tJl r 'da lo Co missloner 111111Z017 I • Office of Consumer Affairs and Business Regulation 10 Park Plaza - SUlte 5170 Boston, Ma ti;iUsetts 02116 Horne Improvemel;'t 1 rector t Registration ('r� .�;:;:� ;•;, ,.� Type; Corporation Registration-, 153587Cape Cod Insulation' Inc Expiration; 12/14/ 2 01818 Rearde Circle So, Yarmouth, MA -02664 eca•,r 41, 20M.0ent Update Address and - return card, Mark reason for change, �s�o��v��oac�uarr�t/oyBG?/�lrtaJ�ro%lWAttJ• .1"!.'�,�.t a..•n:plQ.y.msttt;_�1->,.�.,9!.C,�,u'�4.... OHIO$of Consumer Atfalre&eueinesa Regulation HOME IMPROYSMENT CONTRACTOR Registration valid for individual use only Ty'P'e.t Corporation before the expiration date, If jouno urn tot ,. Offloa of Consumer Affairs and el ss Regulation ;Jti itir• ',... Expiration ;, at ►'t( +y, 6 12/14/2018 10 Park Plaza-.46,49$170 Cape Cod Inow1hi d ��' (:;1+ Boston,M 11 He Cassidy'rt, 18 Reardon 0)r311 �};.� So,Yarmouth, �;t Vnderseoretary t al hout sl atu • c� CAPECOD-27 LEDDLIKE ,d►�oRO" CERTIFICATE OF LIABILITY INSURANCE D 06130120Y7 06/30/2017 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. i 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 policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER C ACT ROgers&Gray Insurance Agency,Inc. PHONE FAX 43 Rte 134 A/c No Ext: Arc,No:(877)816-2156 South Dennis,MA 02660 E-MAI ,mall@rogersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company 24198 INSURED INSURER B:Safely Insurance Company 39454 Cape Cod Insulation,Inc. INSURERC:EnduranceAmericanSpecialtyInsuranceCompany- 41718 48 Reardon Circle South Yarmouth,MA 02664 INSURER D:Atlantic Charter Insurance Company 44326 ' 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP DfYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADE FX]OCCUR CBP8263063 04/01/2017 04/01/2018 DAMAGETSESORENTEDREM occurrence) $ 100,000 MED EXP(Any oneperson) 5,000 PERSONAL&ADV INJURY 1,000,000 L_QEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 X POLICY 0PPET ❑LOC PRODUCTS-COMP/OP AGG 2,000,000 OTHER: B AUTOMOBILE LIABILITY a COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO 6232707 COM 02 04/01/2017 04/0112018 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILYBOODILY INJURY Per accident X AUTOS ONLY X N OS ONLY PROOF Gdent AMAGE $ C UMBRELLA LIAB X 'OCCUR EACH OCCURRENCE 2,000,000 X EXCESS LIAB CLAIMS-MADE EXCl0006635002 04/01/2,017 04/01/2018 2,000,000 AGGREGATE DED F RETENTION$ D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY R/O WCE00431902 06/30/2017 06/30/2018 E.L.EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 1,000,000 �FFICER/MEMg��EXCLUDED? ❑N N I A vlandatory In NH) E.L.DISEASE-EA EMPLOYEE 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space,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) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Town of Barnstable Regulatory Services- : ..�eass Rfc4ara V.ScaU,Dhvdor Building Division Tom Perry.BWldittg Comickdoner ZOO Mdo Sftw%Hyannis.MA M601 Ymw.Wvm bamMbte ma as Office: 508-862.4038 Fax 508-790-6230 Property Owner Must Complete and Sign This Section If Usinz A Builder I,STEVE MERLESENA ,as Omer of the subject pwpeny herebymhorize! tt�(1 w act on mybelralf, its an maaers vela&vm w work authorized byds s bu&rmg perms application for. 84 RIDGEWOOD AVE HYANNIS, MA (Address of job) ~_ Pool fences and a]armt are the responssbs`It'ty of five aplicarn. Pools are not to be filled or uuhzed before fence is k=Ued and all final wspe do are performed and accepted. Sigpatore fCona Signature of Applicant Prim Name Print Name 11 -7 Date QsoarNexer�tssror>ponts � l �K Town. of Barnstable *Permit Regulatory Ser ► Fee 6morahsfrom issue 0 BA date y MASS. $ Richard V..Sca ' Director T1�9 q�R s Eo ` Building Di '; �/.9 1 ZOJ Paul Roma,Building CommPolf 200 Main Street,Hyannis,MA 02601 www.town.bamstable.maus �� Office: 508-862-4038 '&Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY p 3 - I Not Valid without Red X-Press Imprint Map/ arcel Number n( I ( f Property Addresg '6 ❑Residential Value of Work$- (gin J Minimum fee f$35.00 for work under$6000.00 Owner's Name&Address d— f a-W 4 4,1 in 5 AAA. Telephone Contractor's Name f ..� � c�� p Home Improvement Contractor License#(if applicable) J 4 -7'-o Email:' Construction Supervisor's License#(if applicable) ❑Workmen's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name P ✓a✓ 1j,4 S Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompan each permit. Permit Requ (check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to SS Z4 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side h . ❑ 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,Le,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 re iced. SIGNA Q:\WPFILESTORMSUilding permit forms�MRESS.doc 01/25/117 I , Ile Coma:orrivealth of Massachusetts Dep art went of Industrial Accidents - - O,f, -ce o,f 1mv—stigations 600 Washington Street Boston,CIA 02111 mm-nnia-,mgov/dut Workers' Cumpensation Insurance Affidavit Builders/ContracturslEIectricianslPlumbers Applicant Information Please Frint Legibly Nam(BusioessflOrganizatit}n�tndit*idaal} �� �� Address: Cifiyf ,; : dip: W — Phone�` `z � 7 Are an employer?Check the appropriate box: Type of project(required): 1. I am a employer with�_ 4• ❑I am a general contractor and I employees(full,atldforpor!-time). * have hireJ the sub-contractors 6. ❑New construction 2_.❑ I am a sole proprietor or partner- listed on the attached sheet. T❑Remodeling s and have no employees. These sob-c=trac#ors have � $. ❑Demolition wod,ing fix mein any capacity. employees and hoc a workers' [No worTtinsurancers' comp.insurance comp.insurance f 9. ❑Building addition required_] $. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am.a homeouuer doing all work officers have exercised their ILL]Plumbingrepairs or additions set€ o workers' right of exemption per MGL '�' � 'Q°mF- 12.❑RQofrepairs . insa ranee required_]c c.152,§1(4�and we have no employees.(No workers' 13.❑Other. comtp.insurance required-J. •flay Wffcauda that checks box 91 un st also fill out the section below showing their woxkers'compensation policy informations t Homeowners who submit this affidn'u indk-xtmg they are doing all wal and then hire outside contractors nmst submit a new affidavit indicating such_ fC'ontractors that check this boot must attached in additional sheet showing the name of the sub-comractors and state whether or not those entities lime employees. Ifthesub-contnactorshave employees,theymorstpra%d6 their workers'comp.policy number. I ain are employer that is pr4nidijzgitorkers'cottWmsagaiiitmzranceforitiyourplojeesk Reioty is die poticy and jab site information Insurance Company Name: L) It-,, Policy or Self-ins..Lic.;9: Expiration Date: ` ';21, } Job Site.address: ( I le f City/StaWZip: ✓) Attach a copy of the workers'compensation policy declaration page.(showing 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$1,500.00 andfor one-year impriisonment,as we11 as civil penalties•in the form of a STOP WORK ORDER and a fine of up to$250-00 a day as " violator. Be advised o statemeu ma ded to the Office of Inruest gatioms of th. for insur c cavern Liam I tla 7rereby ee�Wfy�undertFrtr ':is and pert afpe jar}fiat Elie infarnrn#iora prmirFed abm�s is 6u$a?rd correct Sie�ature Date- Phone 9- -7 6 Offlaeial use only. Do not mite in this area,to be completed by city+artolm officiet City or Mma: PermitUcense 4 Issuing A.nthority(circle one): 1.Soard of Health 3.Building Department 3.Cityffown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: tnformatian and Instructions Massachusetts Geirezal Laws chapter 152 regah=all employers to provide workers'compensation for their employees. Pmsrranttn this side,an ewTIoyee is defined as.- ..every person in the service of another under any contract ofhh-r, express or impliocL oral or written." An Moyer is defined as"an individual,partnership,association,corporation or other Iegal entity,or any two or more the le sentafives of a deceased employer,or the of the foregoing engaged inajomt entergrlse,and including gal repre receiver or trustee of an individual,partnership,association or otherlegal entity,employing employees. However the owner of a dweIHng house having not more than three apartments and who resides therein,or the occupant of the - dw-eHi a house of another who employs persons to do maintenance,construction or repair work on such dwelling house or oa the grounds or building appuurtenant 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 is the commonwealth for any applicantwho has not produced acceptable evidence of compliance with the insurance coverage required." Additionally.MCrL chapter 152, §25( (M states"Neither the commonwealth nor any of its political subdivisions shall enter ink any contract for the performance ofpublio woik until a meptable evidence of compliance with the in scum ce._ requirements of this chapter have been presented to the confracting authority." A-PPHcalits Please fill oht the workers'compensation affidavit completely,by ch=ldaguu the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone numbers)along with their certificate(s)of insrrranc0. Limited Liability Companies(LLC)or Limited LiabilityParfnerships(LLP)with no employees other than the members or partners;amnot regrm:ed to carry workers' compensation insurance. If an LLC or LIT does have employees,a policy is rmgnired. Be advised that this affidayif maybe submitted to the Department of Industrial Accidents for confirmation of in�c.P coverage. Also be sure to sign and date the affidavit. The affidavit should be retuned to the city or town that the application for the pem3it or license is being mquested;not the Deparfineat of - n , A_ccidmts. 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 nmmber listed below. Self-insured companies should enter their self-m sur nce license nomber on the appropriate line- City or Town Officials . f _ Please be sure that the affidavit is coin_Iete and priifed legibly- The Department has provided a space at the bottom of the affidavit for you to fill out in tare event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in.the penm;t cewc number which will be,used as a reference number. In addition, an applicant that mnst submit multiple pemritllicense applications in any given year,need only submit one affidavit indicating current policy inkrnation.(if necessary)and under"Job Site Address"the applicant should write"all locations in (cit'or awn)."A copy of the-affidavit that has been officially stamped or marked by the city or town may be,provided to the applicant as proofthat a valid affidavit is on file for future permits or licenses. A new a.ffidavitmust be tilled oirt each year.Where a home owner or citizen is obtaining a license or permit not related.to any business or commercial venture tie_ a dog license or permit to bum leaves etc.)said person is NOT regakc d 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 atidress,telephone and fax number_ 'II�e�Q�nw�th of Ma�ach�etEs - - Deparment of In dial Acaidentq �ff7tee r�Xitve�?g�fiop,� �QQ�asl�in�tQn � Bwtajcl�M&G� I II T(,-L 4 6I7 727-4900 Qxt 406 or I-W -MAS AFF Fax#617` 27-7749 Revised 4-24-07 .mash ggvjdia �VE ToWn of Barnstable Regulatory Services : r t Richard V.S Director - uv►sa , tali, Building Division. Paul Roma,Baildmg Commissioner 200 Main Street,Hyannis,MA 02601 . www.town.barnstable.ma.us Office: 508-862-4038 _ F= 50&790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, �l L�ti1�� /qL_9-ILT C 64 ,as Owner of the subject property hereby authorize 7 C 0, 1 (` Ca-CACx_ to act on my,behalf; in all matters relative to work authorized by this building permit application for: o` P(I'U0cP AV cam' LlW(,I'tS (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence,' talled and all final inspections are performed and accep _ ignatute-of Owner tore plicant y U C� M c& tj Print Name Print Dame ` Date QTORMS:OWNERPERMMSIONPOOIS ° Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division • BARNarwau. Paul Roma,Building Commissioner � 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 HOMEOWNER LICENSE ExE WPTION 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( )who owns a Ps arcel 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 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 EXFZdMON 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 shail-act as supervisor." Many homeowners wbo 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. fully aware of his/her responsibilities,man communities require,as art of the To ensure that the homeowner is fu y p , y eq P 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. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 0620/16 ,.""""..:,""..."' "..p"' ::.. ..-..: "".." .."..../ .ca 'J/r@ �a/rrdiranu,�nnaaf�v!•ZCIJJO'C'/[!UC'!!5 ' Board of Building Regulations and Standards : Office of Consumer Affairs&Business Regulation Licens CSSL-090828 HOME IMPROVEMENT CONTRACTOR onstruct�v�34" ervisor Specialty Registration:: 165907 Type: Expiration— !8 Private Corporation TED L HITCHCOCK TL HITCHCOCK CQNStFUG 1�tt SERVICE INC. 55 LISA LANE WEST BARNSTABLE MA 02668 THEODORE HITCHC_OGK<—: 55 LISA LANE WEST BARSTABLE,MA 02668 Undersecretary Expiration: ,. Commissioner 06/0112018 r 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 01116 /t Not valid without signature r Page 1 of 1 2017-04-1012:58:25 EDT 18665443184 From: Anne Sanzo DATE(MM(DDIYYYYI 14�cCERT'IFICATE OF LIABILITY INSURANCE F0411012017 THIS.CERTIFICATE IS ISSUED'A$.A MATTER OFINFORuATION 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 pollcy(les)must be-endorsed. if'SUBROGATION iS WAIVED, sub)ect 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 508-946-7863 IC,No 2-65 ORLEANS ROAD E-MAIL ADDRESS! N.CHATHAM MA 02650 INSURE S AFFORDING COVERAGE UAIC# INSURER A: 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 NUMBEi2: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE.MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFPORDED.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, W SR ADDL SUBk POLICY EFF POLICY EXP LTR TYPE OF WsURANCE in&YZIMPOLICY NUMBER MM/DO MIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMN311 TO RENTED COMMERCIAL GENERAL LIABIJTY PREMISES Ea occunenee $ CLAIMS•MADE D OCCUR MED M_ one Person _ „ PE-RSONAL&ADV INJURY $ t GENERAL AGGREGATE $ GEN'L AGGREGATE.LIMIT APPLIES PER k PRODUCTS-OOMP/OP A00 $ POLICY PRO. LOO E€ $ - OMHINEU SNdGLE LIMI f AUTOMOBILE LIABIIITY au dons ANY'AUTO . - .. BODILY INJURY(Pat der3An) $ ALL OWNED .SCHEDULED BODILY INJURY(PeracNdenl) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED.ATO$ AUTOS Per RmIdent UMERELLA.UAS OCCUR .. - EACH OCCURRENCE $ EXCESS LIAS CLAIMS-MADE F w' AGGREGATE $ DEO RETENTION$_...... 1 S WORKERS COMPENSATION J.WC STATU- OTH- fORY FEL AND EMPLOYERS'LIABILITY 1 000000 ANY PROPrRIFTOR/PARTNERIEXECtiT N`E. YIN E.L.EACH ACODENT $ OFFICERIMEMBER EXCLUDEDz. •..0 N.IA 7PJUB2E101644 ' . 03f26/2017 03126IZQ1.8 " •.1000000 (Mandatory in NH) ESL DISEASE-EA EMPLOYEE $ d1 F� .L,CIP7NbPAI Sbelrnv E DISEASE-POLJCY LNu11T. :$-: 1000000 i a _ i �• yr DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (Attach ACORQ 101,Adoitlonal Romarks Schodvlo,If more space I*requlred) s� 3't CERTIFICATE'HOI_DER CANGELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES'$E'CANCE"ED BEFORE TOWN OF-BARNSTABLE THE EXPIRATION .DATE THEREOF; NOTICE. WILL 8E DELIVERED IN 20O.J AIN•STREET ACCORDMbE WITH' ®daWnf t,OIWW En land,'LLI IiYANNIS,MA 026Q1 Au nloR�xgu R Pfa sEM;A11IVE r•'.. ACORD 25(2010105) ©1588 2010 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Gy 2 Map Parcel .­Z19n A _ TA L ,, Permit# d 09, Health Division Date Issued '5' '510 S 0 C6 Conservation Division Application Fee Tax Collector at 10 Permit Fee A .Ir;d Treasurer Planning Dept. CONNECTE S Date Definitive Plan Approved by Planning Board # Historic-OKH Preservation/Hyannis Project Street Address �i i6n e L-j o c - Villageilb?,m, r -S I Owner Address 4 Telephone - n . Permit Request -�-`� C.q y U, R Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation f S, 4-d-V, c-0 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family [/ Two Family ❑ Multi-Family(#units) Age of Existing Structure io Historic House: ❑Yes U.No On Old King's Highway: ❑Yes tf KIS Basement Type: ❑Full ❑Crawl ❑Walkout 0 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, 0 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:0 existing ❑new size Pool: 0 existing ❑new size Barn:0 existing ❑new size Attached garage:❑existing ❑new size Shed:El existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial-O Yes__...O.No__If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION, S' Sr" -7 Name Telephone Number K2- 2,:� Address J License# C f 01 6 / f 7 fS 0437 Home Improvement Contractor# Worker's Compensation# ALL CONSTR CTION DEB IS R SULTING FROM THIS PROJECT WILL BE TAKEN TO A C- J 1 . SIGNATURE DATE (J `T— FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED c, •, MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF-INSPECTION: ' FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL Q I •ITS}• r PLUMBING: ROUGH S FINAL RR !V GAS: ROUGH FINAL ;. C7 FINAL BUILDING rn • � •R DATE CLOSED OUT ASSOCIATION PLAN NO. p t Town of Barnstable Re ato Services'• rY . � nnnrtsras�, Thomas F.Geiler,Director, Boilcling Division Tom Perry, Building Commissioner 200 Main Street, IiYmais,MA 02601 www.town barnstable;ma.us 1, Office: 508-862-403 8 Fax, 508-790-6230 Property Owner Must , t Complete and Sign This Section If Using ABuilder ' I, 1 ,as Owner of the subject property' e K. C�-►��rJ to act on mybeha hereby authonze 1 _ lf, in all matters relative to work authorized by this bunding permit application for: ; (Ad• ss of Job) 411 �y� Date Signature o�0-v Print 1'dame . ' • ' - • _ - a -�..... rn.mtn.TvtiaT.9AfT.CCTCIN " f _ -The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street, 2` Floor Boston,Mass. 02111 ~ J�Vyorkers'Compensation Insurance Affidavit: �. ,... 1 $D r 07t�•' „.; ti ;I��,i'j Buildin i lu•mbi;;-N., [Electrical''-�r..� Contractors ontractors n � �name: '�'i C . ! CJ ✓' ' address "' J�(� ►/un City state: zi hone# �'✓ C Z i work site location full address). Lo :L r / D e y 2 ❑ I am a homeowner performing all work myself, Project Type: ❑gew Construction,❑Remodel Q-lam a sole a proprietor and have n�oa�one working in an capacity. ❑Building Addition 1.hr..-n'a'..3 !r;.E�.C'?. F�•;.air .,'w .�P'yt'V"^.�T7Y�+ .. '4� .�c"'73c lk%. '' ?`., ...3 �1'.:�'s's J �.s•'. .�"iy�.'.Ra ; .'�`: ., %i:�.?. ^.,G.?c;:.. "i�'.TC�,� ❑ I am an employer providing workers' compensation for my employees working on this job.. company name: - - address: city phone#, insurance co. ]ic # ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers'compensation polices: 4 companv name: -- address: city: phone#: -- - �i�nssuurra�n volleyp. •' •w#c 'l.T:w�.•i.P` �Gi . .YC .rXt '.�".�'f.3'6rn. t-T'. 'lv .�fR•�'..i'Mt'c^.K'!�.x ..ti.'. � r^v:Y:L.6u. yl:'1'Y::'id�=-!JWi➢.• company name: address: city: phone#: - - Insurance co. oti # Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify th pins•a -penalties of perjury that the information provided above is true and corre ` a - Signature Date Print name ��-[i!'1 'Z t n- Phone# official use only do not write in this area to be completed by city or town official ' city or town: permit/license# ❑Building Department ❑Licensing Board Co check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised Sept.2003) - ,b. 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 i Please'fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,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. np p IIII IA I lAr}rl Ilnl 1 AI IP ir•I _ 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 permit/license number which will be used as a reference number. The affidavits may be returned to 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 call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext.406 Town of Barnstable - ' °� Regulatory Services Director I s aHrs. Thomas F.Geller, NAM 161; a,�'� Building Division Y rE'D MP'� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 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 foul dwelling units or to structures which are adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. (} Estimated Cost Type of Work: ; Address bf Work: Owner's Name: Date of Application:_ 4 , I hereby certify that Registration is not required for the following reason(s): , []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THMIR OWN PERMIT OR DEALING WITH UNREGISTERED T WORK DO NOT HAVE CONTRACTORS FOR APPLICABLE HOME IMP ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL c.142A. SIGNED UNDER PENALTIES OF P Y . I hereby apply for a permit as the agent of the o v Registration No. ` Date Contractor Name , OR Date Owner's Name A Qifarms.homeaffidav RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE , New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 D• r CI Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041— plus from below,(if applicable) ALTERATIONSMENOYATIONS OF EXISTING SPACE square feet x$64/sq.foot= .S D 0 D x.0041= l• S plus frombelow(if applicable) GARAGES(attached&detached) square feet x$32/sq.S.= x.0041= ACCESSORY STRUCTURE>120.sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf . . 50.00 >750 sf-1000 sf w 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041- STAND ALONE PERMTS Open Porch x S30.00= • � :� (number) - ' Deck x$30.00= (number) Fireplace/Chimmey' x$25.00= (number) Inground SNAmmingPool $60.00 Above Ground Swimming Pool S25.00. Relocation/Moving S150.00 (plus above if applicable) o6 / Permit Fee projcost w_..J1L1If1A ' J • A' ...+..—,-... .`.. ,._ .. ...._,.ve,.._+.. ..... ....-�..„-+...4:+...-.+.,«..+oa a.+ i _._ w T .+.' ......_.—..a Wrw-Nw+�._•+.Aw< u...n.r.... 57 J 0/` °aa�l Board oCBnilding Regn oons and Standards HOME1M OVEMEWT CONTRACTOR Regist[ 1.OtI03$.. Woos ual ALEXANDER C. a Alexander Blair 4291 MAIN ST. CUMMAQUID,MA o263 Administrator GTI�e -Pomnzauuea� ���aaoac�ui�eka BOARD OF BUILDING REGULATIONS License: ,CONSTRUCTION SUPERVISOR ..4:Y� .. Number;,_C5 016187 Birthda '� Exp re;: r7/16/2005 r � ` o: 14175 r' Retnc�ed ')0 I` A XANDER C.� PO BO L .. CUMMAQUID,. MA Administrator • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map (� Parcel Permit# qA30v' Health Division Date Issued � ��� -moW* Conservation ivis'on Fee 6 ~'- Tax Collector Treasurer lzdaa Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 4 �-t C��•e tAj 00 Village C�101 V\t S Owner 1 e - b ��y1 Address Telephone Z' Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation t3 E Zoning District Flood Plain Groundwater Overlay Construction Type ` Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family W Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: Cl Yes [rho On Old King's Highway: ❑Yes 01N0 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 BUILDER INFORMATION Name W N c� Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO niSocii�-° SIGNATURE DATE -6 2Sr0—d FOR OFFICIAL USE ONLY t PER-MIT NO. DATE ISSUED ' <� MAP/PARCEL NO. t ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: FOUNDATION FRAME ' INSULATION t( ,FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL ' 'r GAS: ROUGH FINAL ' FINAL BUILDING ! DATE CLOSED OUT • ASSOCIATION PLAN NO. s ------ The Commonwealth of Massachusetts • "-'� -! Department of Industrial Accidents c;;;r== Office ofioirestioatfoas 600 Washington Street , y it Boston,Mass. 02111 ` workers Compensation Insurance davit //////// ....i... :22: j// name: locaticn7 # city hone [ I am a homeowner performing all work mv5eif. I am a sole pro rietor and have no one workng in any ca acity [ I am an employer providing workers' compensation for my employees working on this job comnnnv name: address: _ ........:..: . ..... . .:.. , hone,#r city: oiicv#:.. msur e �n [ sole proprietor, general contractor, omeowner ' cle one)and have hired the contractors listed below who have the foilo«1ng worker s' compensation polices: comn1nv name :, . .. .address: � � x:Gi: • gt:� ti;,3�e�� ►'` '� ct amnnnv name: :.....: -.:: :::::<>::::;;.:::, address: »: one#. citN7 _ .. insurance co. Faiiare to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties agaof inst fine up to understand and/or one veac�'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against ma I understand that a one ea this statement may be forwarded to the Oltice of Investigations of the DIA for coverage verifleation. cop1 do herehv certify under the pairs and penalties of perju at the information provided above is true and correct f rra-Date $1_'LIlAtllr � e V&Siff)Li A)i p,,k C,-t (;�CI)2 2, print natne 'o'illci i use oniv do not write in this area to be completed by city or town ofIItial permit/license# ❑Building Department •. city or town: ❑Licensing Board • ❑Selecanen's O1$ce . M check if immediate response is required ❑Health Department ❑Other contact person: phone#; ,i 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 corny.:; 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 or the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver trustee of an individual,Partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartrurerrts and who resides them, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work ou such dwelling house or on the grounds c 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�ag omm shall for any appold the licant who h ce or rene'V of a license or permit to operate a business or to construct buildings a " not produced acceptable evidence.of compliance with the insurance coverage required- Additionall .;tineither shall eater into any contract for the performance of public work until commonwealth nor any of its political subdivisions acceptable evidence of compliance with the insurance requirements of this chapter have been presented to.the cont-ractm authority. f Applicants • the box that applies to your situation and r Please fill in the workers' compensation affidavrt.completely,by checlang 4 supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be h for confim3ation of insurance coverage. Also be sure to sign and submitted to the Department of Industrial Accidents hcation for the emuit or license us t date the affidavit. The affidavit should be returned to the city or town that the app P _�_. YC Accidents.a Should you have any.questions regarding the`law being requested,not the Department of Industrial, _ are required to obtain a workers' compensation policy' Please call the Department at the number listed below. / IM / l 1:. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of t affidavit for you to fill out is the event the Office of has to contact you regarding the applicant. Please be sure to fill in the pemiitllic®sa number which will be used as a reference number. The affidavits may be returned to the Department by main or FAX unless other anzngemcnts 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 call. 'the Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Iwesduadons -- 600 Washingto n Street _ Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 i THE T The 'Town of Barnstable 9 Kam$ Department of Health Safety, and Environmental Services {.`° Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-862-4038 Building Commissio—, Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PE Wr APPLICATION MGL c. 142A requires that the"reconstruction,akterattons'renovat'on'repair'modernization,conversion, improvement,removal,demolition,or construction of an addition to any , over-occupied building containing at least one but not more thaw font dwelling twits or to sftc=cs which are adjacent to such residence or building be done by registered cnn actors,with can exceptions,along with other requirements. ((�� Type of Work: 1� e no® Estimated cost Address of Work: Owner's Name: Date of Application• < (zS I Cr I hereby certify that: Registration is not required for the following reason(s): E3 Work excluded by law [3Job Under$1,000 rIBudding not owner-occupied (Owner pulling own permit Notice is hereby given that: REGISTERED OWNERS PULLING THEIR OWN PERMIT ORDER+M WORK WITH UNREGISTERED NOT HAVE CONTRACTORS FOR APPLICABLE HOME DMMOV EM W M FUND OR UNDER MGL c. 142A. ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. ate owners Name The Town of Barnstable DFINE Tpk�O Department of Health Safety and Environmental Services Building Division BMWSrAI ' 367 Main Street,Hyannis MA 02601 MASS. RFD MA't A , Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: CA JOB LOCATION: ,& number ceestreet / jvillage b "HOMEOWNER": ( e 1�^ l� 1 t3 )� 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 "µBuilding 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 proce0les and requirement, Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1� Map 32� Parcel 2 ( � Permit# 7-Q _ Health Division Date Is ed 0/7�2 Conservation Division Fee' �� Tax Collector Treasurer YN ) , Planning Dept. . l Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 4 (Ap_uji a-od `A Uz Village G�1n\A t S Owner � �7tle �b S Address ��� �Oc�✓ ��G"" . Telephone Permit Request er O 0C 5—A Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost��t O Zoning District Flood Plain Groundwater Overlay 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 (�Z� Historic House: ❑Yes 1 2 No On Old King's Highway: ❑Yes 04a0 Basement Type: Ur ull ❑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 BUILDER INFORMATION Name �� CG S r�(x �tR�1/� o� ?Jb Z Telephone Number Address License# PA QV,©�e J l G� t ����`-� Home Improvement Contractor# Worker's Compensation# lra�d-��G1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 'Sams, SIGNATURE _ L DATE Q FOR OFFICIAL USE ONLY PBRMIT NO. r" DATE ISSUED MAP/PARCEL NO. . r.F ADDRESS W- ,T VILLAGE _ OWNER r � DATE OF INSPECTION-:s FOUNDATION r FRAME — INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL _ PLUMBING: ROUGH "' FINAL GAS: ROUGH a FINAL FINAL BUILDING f ' DATE CLOSED OUT ASSOCIATION PLAN NO. e Town of Barnstame 16 9�' Department of Health Safety and Environmental Services TEo, Building Division F 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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: Estimated Cost A Address of Work: Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): W excluded by law ob Under SI,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MOROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY l hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR DateOwner's Name #brms:Affidav M CLOt wppowk i - ' TableJ&2Jb(andameaq • Presmxipdve Packages for sae and Two-Femily RaideneW goudtap gated with Fossil Fads - MAXIMUM MWIMUM Glazing Glazing caling aau Floor I SlabArm'(%) U-Yalae? R-Value' R vdue/ &values Gall Pia �Pm� EMR�&Value' 5/01 to 6500 Heads;Degree Darr' Q 12% 0.40 38 13 19 1 10 6 Normal R 12% 0.52 30 19 19 1 10 6 Normal S IrA 0.50 33 13 19 1 10 6 U AFM T 15% 0.36 38 13 25 WA WA Normal U 15% 0.46 38 19 19 10 6 Normal Y N%. ibF4 �O 13 2J ryM WIA ttS AFUE a 13% M52 1 30 19 19 1 10 6 15 AFt1E X 12% 0.32 1 33 1 13 2S WA WA Normal Y 19% 0.42 33 19 25 WA WA Normal t 18•/. 0.42 32 13 19 10 6 90 AFUE AA 1 r/. OSO 30 19 19 10 6 90 AFUE I. ADDRESS OF PROPERTY. 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING. 4. %GLAZING AREA(#3 DIVIDED BY 92): 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: q-forns-080303a 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 ftZ 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 me conaiuoned space auu u,c vc„u '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 basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. '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 J5.2.1 a 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). 43 _ _= e 1 c '. - Department of Industrial Accidents ri -- _ ` :: = O/f/ce 81/0e50899ns . .• 600 Washington Street c�I Boston,Mass. 02111 v Workers' Com ensation Insurance davit name: q:�-6N��f.. (5rV-6 s,c� location- �q i A`A g�^W O—,,� A` ".e �j city e,_1 � hone# �o I& r-•3 LZ^3Ci d I am a homeowner performing all work myself. anv ❑ I am an employer providing workers' compensation for my employees working on this job. :::::::::: ::: comaanv n :::....-:.. .:..::::...:.:.:.:.::.;:.::::.;:;.;:.::.;;:.::..::.::.:.;.:-::.::.:;.::.:..::.:::".....:::.:.. ::;>::>::;::;>;:;:::.;;:.:::.......: ........ . . % .::;:.:::.:.4:.:. .......... ............................:::::::::.:::::.:. :::._:::::::::::::::•.:::................ :::: city' n Mine#. :;< ;:.;:.;:.;:.::.:;:::::.>..;::.;::.......;:.;:.::;;:.;;.::.;:.:;:.;:.: insurance co.:" ... olicv# :.: ......::::::::;•::.:.: ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have . ers' compensation polis:ce the following work ......:::::..:::.. comyanv name. .::::::.::::. ::. address. ... ::>;>.;;:::::::>:.<..>:::.>:::;::>:.. :.. ......: ...::.:.:::::::: :: ;:;.:::::....:. :..: . ... .. ........... .. ..1. ..........:..::::.:::::::.......................;.......:.::.�.............................::.......: �::.:................ :::::: ::::...:.:::::::.::::.:.: .... . . ..::....::::.*."-,.:::::::::....... ...::X.: X..:.:::::..::::...:.:..::.... city ohtin ..::::.::::::. . . .............. .............. ......................................... >:<>w;< _ . . . .. ti�icv //%%I%//. camoanv.name: ... . ...::.;;:;:.:;:.;;;.::•::::.;•::.:.:::::;::;;:.;.;::;<.;.:•;: ;;;;-:::.:,:::;::.;::. :. :.:...................................::::::::::::::::.::::: address: city ... ::::.. <: :> iM nrance co.: :' :: .. . li Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is bw and correct Signature Date — , Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# QBufiding Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office _ ❑Health Department contact person: phone#; ❑Other (revised 9195 PIA) 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, employi ng employees. However the owner of a dwell' house having not more than three apartments and who resides there' or the occupant of the dwelling house of � � P m, P � 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 permit/license number which will be used as a reference number. The affidavits may be returned to 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 call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of imtesugadolls 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 Department of Health Safety and Environmental Services Budding Damon ttr� 367 Maas She=,$YWds MA 02601 Raiph Office: 5084= 4038 ry CbUmmisric Fax: 508-790-C30 B HONMOWNMLU�TME Muni"" DATE=.,,r( � roe i =zioN: aaa� so= k Viaw C,u VyiV�^c� v �•d p (-� moa aP coda �,� a was©emdedto incbtde afsizu�or iess The ocempdam for wot possess License, and to ailoado w homeowne:3 to enpe M iadividuat£arhueho does n SGL�.SS�i�SOL pgH�OME09YN1F.Q pasm(s)who owns a pad of land an which hdsbe resides ar iaomds to noid4 an which there is,or is ftMded to be,a ane or two family dwe&S xndmd or deumhed sazmrm acccwmY to sm&me=dlar farm M=tmzL A p=mwho rm - mmthsa anchamme iaatwo_r tpmdodsbalabeconsidazdahaamne. Such shall submit to the Htn'tdmr.O-Tiaiai an a form==Puma to the AMMM OffidAk that fidshe A. i_a l be • ecdon 109.L1) ,W 01 ww" � ,for�IM artlh the shoe Bn>lding code and other gppfiaMe codes,byl=4 ndes aadiegnladom Thu meted"h =dffesthuWshe uadecona the Tawn ofHmslable But3ding D Ow j minimum MWM=PmwW=and nq===mdtbathdsbe vIM campiY whh saidprmedtnzs and AWwvOiGfoMcmi Noce: 'lb=fiY dwdlmga B 35.000 catbaa£eet or imW vM be milked to compiy with the Staoe Building Code Salon 127.0 Consomcd=CounaL sOMEGWKM ZMEMMUR is sill be: ftaa dta i wCodsssomdw "Auyfm ownalFdM2=w*ftfwd* io6 itffiebmmwnamg aPww*alfor PowisbMauftsodaaiumio9.u•li=MgatwMMdm x Mwwdom&aarjC.dW CkFAMowaeesldiaaass"WbO " � ��G(a=+a�tswpP�°,Q, �r homearweea ado aa4 dtb�a ato===d oftr �1�R fw�C0 Mc*u-4 d0O omop�aso�maodn ic=sc =pc =ui rai�eat�eimmeosiaaeithauwwMdgM IaftAe•Offsawd diemsedPasonssitao+dd VA&aljowwsuPasiM IbbMwMerwftw8apa risuldmm* OOM �r t aspatoftbep 'w0°' To wmetbadtattomeastmeris ►swaee afhisfia of� Oadta is "FGfd&iwe is afmm=cWy uud dwftbOMOI by scram towns. Yon MT CM w amend and adopt such afmmloat� IL to V 61/1550 � I- -q -( i 4 , 4(_4 So t-lo ru ge -`l _,_ ,. '.r � � 9 j ,_ i ♦ E C f. ©LO 1 C w . � F • � ` w �_ r I � � I � � F TOWN OF BARNSTABLE DEPARTMENT OF HEALTH SAFETY AND ENVIRONMENTAL SERVICES BUILDING DIVISION 367 MAIN STREET, HYANNIS, MA 02601 TELEPHONE: (508) 790-6227 FAX: (508) 775-3344 July 28, 1994 Mr. Maxe Cesar: 84 Ridgewood Avenue Hyannis, MA 02601 Re: 84 Ridgewood Avenue, Hyannis, MA Map/lot 328.218 Dear Mr. Cesar: This office has been notified that a bicycle repair and sales business is being conducted at the above referenced location. Please be advised that this property is located in a residential area and a business of this type is not allowed. Also, during an inspection of the premises, the following wiring violations were noted: illegal use of extension cords in cellar and extension cord use in second floor bedroom. You are ordered to correct these violations and to CEASE and DESIST this business immediately. Very truly yours, 4 i fred E. artin Building Inspector AEM/k it - - cc: Director, Health, Safety and Environmental Services Ms Diane R. Gibson, property owner { i Town of Barnstable ti Regulatory Services &'RNST"B Mass. Thomas F.Geiler,Director yQ � "Op •i639 ♦� tf1639 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: 84 Ridgewood Avenue,Hyannis MAP/PARCEL 328/218 PROPERTY OWNER: Diane R. Gibson 149 Harbor Point Road Cummaquid,MA 02637 This inspection was conducted at 10:00 a.m.,May 2,2001 in response to a complaint received by the Building Commissioner's Office. A building permit,#40457,was issued August 17, 1999,to replace steps to the front porch. Our records show no inspections were done. The steps are in place. There are no hand rails installed or railings installed per the plan that is on file. Several pieces of gutter were rotted and missing. Several side wall shingles were rotted and the trim was . rotted with several sections missing. There were two unregistered vehicles in the rear yard: 1 Mazda pickup and 1 Toyota Tercel. There was a I car garage in the rear yard with no shingles on the roof. This garage was loaded with debris. There were engine parts,tires and bicycles around and behind the garage. The six foot stockade fence was in disrepair.. Several sections were down and rotted. The entire yard was a mess. g010502c Assessment Reults Page 1 of 1 84 RIDGEWOOD AVENUE . Map/Parcel/Parcel Extension: Mailing Address: 328/218/ GIBSON, DIANE R Owner of Record: GIBSON, DIANE R PO BOX 131 Property Location: CUMMAQUID, MA 02637 84 RIDGEWOOD AVENUE Parcel ID;328218 G v/Z X" http://town.bamstable.ma.us/Information_Ol/Assessment/results.asp?mappar=328218 5/2/01 f °FtMME• Town of Barnstable ti Regulatory Services r r ■ ea ASS.i a Mass.. Thomas F.Geiler,Director y M ,� �A 1639. �0 rED11�,tA 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 /t, 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 Frank W. Gibson P.O.Box 131,Cummaquid,MA 02637 phone: (508)362-3981 fax:(508)362-4812 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. u v\(-ae,�`� a-1-" �..p oF� The Town of Barnstable snnrsr,►ai.E, • MASS Department of Health, Safety and Environmental Services DOTED Mfg" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner June 30, 1999 Mr. Frank Gibson PO Box 131 Cummaquid, MA 02637 Re: 84 Ridgewood Avenue, Hyannis (328 218) Dear Mr. Gibson: This letter will confirm the fact that at our meeting on 6/28/99 you agreed to take out a building permit for 84 Ridgewood Avenue to repair front stairs. Additionally,you agreed to clean up the exterior by removing the junk on site and painting the house. We think these changes will make a huge difference. Thank you for your cooperation. Sincerely, Ralph M. Crossen Building Commissioner RMC/lbn g990630b � "` °FfF1E The Town of Barnstable 9e� 9. Department of Health Safety and Environmental Services ArEp '�" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner April 12, 1999 Mr.Frank Gibson P.O.Box 131 Cummaquid,MA 02637 RE: 84 Ridgewood-Ave Hy annis,yA''IA 02601 Dear Sir: While investigating a complaint forwarded to this Department by the Hyannis Fire Department,I observed some serious violations of 780 CMR. Specifically the Mass State Building Code CMR, Section 121.0 through 121.6. In order to avoid further action by this Department you must immediately begin work to bring this structure into safe compliance. A Building Permit will be required in order to perform this work. If this office can be of any assistance please do not hesitate to contact us. Thank you in advance. Sincergly, Richard Stevens, Local Inspector cc: Tom Kenney g990412a RA, The Town of Barnstable ' Department of Health Safety and Environmental Services " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Fax: 508-775-3344 July 28, 1994 Diane R. Gibson P. O. Box 131 Cummaquid, MA 02637 Re: 74 anted 84,Ridgewood Avenue, Hyannis, MA Map/lot 328.22"& 328.218 Dear Ms Gibson: During an inspection conducted July 20, 1994, the following violations were noted at 84 Ridgewood Avenue: 1. Illegal use of extension cords in cellar and extension cord use in second floor bedroom. 2. operation of a bicycle repair and sales business in a residential zone. Please notify this office when these violations have been corrected. Please also note that the electric power at 74 Ridgewood Avenue has been disconnected due to various violations. Very truly yours, Alfred E. Martin Building Inspector cc: Director, Health, Safety&Environmental Services - r �_ } `` �_ 1 c � �� �� �,,� �� � � V ''�� a t. � � � r OFF The Town of Barnstable mDepartment of Health, Safety and Environmental Services '- 1 ,jg. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner June 30, 1999 Mr. Frank Gibson PO Box 131 Cummaquid, MA 02637 Re: 84 Ridgewood Avenue, Hyannis (328 218) Dear Mr. Gibson: This letter will confirm the fact that at our meeting on 6/28/99 you agreed to take out a building permit for 84 Ridgewood Avenue to repair front stairs. Additionally,you agreed to clean up the exterior by removing the junk on site and painting the house. We think these changes will make a huge difference. Thank you for your cooperation. Sincerely, Ralph M. 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