HomeMy WebLinkAbout0019 SAINT CATHERINE AVE i
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t Town of Barnstable *Permit
Expires 6 mon hs jro su date w \
Building Department Services fee �. ---,
rinxxsrest.a Brian Florence,CBO - _J
9 1 Building Commissioner
•
Ao• �r. 200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax:508-790-6230
EXPRESS PERMIT APPLICATION = RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number — �► .�
Property Address S'4/�1i C � �r%�� �� /�Jq'_7171) / l-I rj2615 /.
Residential Value of Work$ > Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address -5-vq, [JGl
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable) Email:
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance o
Check one:
❑ I am a sole proprietor �a
I am the Homeowner 5+
I have Worker's Compensation Insurance r®�1/ kP
?01
Insurance Company Name
Workman's Comp.Policy
Copy of Insurance Compliance Certificate must accompany each permit. i
Permit Request(check box)
f Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side .
❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows
#of doors:
F
*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
requires
SIGNATURE:
QAWPFILESTORMSlbuilding permit forms\EXPRESS.doc
08/16/17
41
?Tie Cammomvea&h gfMssr diusetff i
D merit o,f rudushial Accidw&
- Office 60M.Whovions
600 Washijigton'Sheet
Bc Suitt,CIA O2111
i mmumamgov/dirt ,
Workers' Compensation lnsurauce Affidavit:B.uildenIContractGl sMw&cianslPlumbers ;
Meant Infarmatrun Please hint
1 Na= cin��ciYYr anrr nnlfnd _ t�GJfl/ V �2 S
Addresr
14 ®46r Phone
Are you an employer?Checkthe appropriate box: Tye of project(required)_ L
1.❑ I am a employer with 4 O I am a general conusrtor and I 6. .0 New o�shuctsOi2
employees(full and/or par�tyme *• 'have Ixired tlxe sulr�OrrhraOrs .,
2.El I am a sale proprietor or pas finer- listed on the attached sheep ?. ❑Remodeling
These sub-contractors have
slop andhavenO employees . 8:-❑Demolition
tv orrarem f employees and Lamwodaxs'
�' �3` ` 9. �-Building adxiifiorF.
INN 'comp.insures�e COOP-ms�rar-V $
offices have�esercised their
recluued 1 5.•El We are a corpom i m and its 14-0 Eleehicai repaiF ,��s ax ations
3. I am fiameoumer doing all Fmk1LQ Plumbsngrepaiza or additions myself, .�
' of on per MGL
� [No waikus c mpr_ Tight egenrpft p 17 Of repairs.
c.152,§I(4�and we have mo
employees-[No workers' 1 .❑'Otfier '
cam-msuc'aace required_]
.*AayWfcm&dmtcbecUhas,¢l—stdsoffioutthese daaheIowshoWngdmkwa&erec mpenmticmporcyisfoamts i=-c
I Homeoamers who submd dais af¢dmit 1uTkatiag they am Anion aIIwaais sod&mId a autsi&contict,.-A splamit anewafriidaeyt inticatmg sash__
/Co odors 1M=e,wx iW lox must sttach m addig-sl sheet amiog thenane of ffie sur-cent-actm sad stda whether ar aatf mse amities liar
employees.I€tba:sub-coatxdEs have enployw;&eyamstp=ide their warkeW Camp.PaIkY amnbet �.
I am an exeploy�ar€/errl isgrm ue, tvrrrkers'caexp eresrcfiart iuszirarres for ex eaxpiny�es $eTvIv is Ae pv icy"d jolt srte,
ir�orrrruuafion. " a . ,
Insurance Company Dame:s
Peficy or Self-izrs.Lic. , _. Expirafiion Date_
Job Re A&Iress - Cify/Staw p: - ..
Attach a copy of the work-ere compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required.under Section 25A of MGL c-152 can lead to the imposition of criminal penalties-of a
fine up to$1,500-OD and/or One-yearimprisor as w611 as civil penalties.in the form of a STOP*ORF ORDER-and a fine
of up to$250-Da a day against the-dolatar. Be advised that a copy of this statement maybe f wwirded to the Office of '
Immst gations of the DIA for insurance coverage boa
ri`o hereby l under the pains artdpenal ¢s a.�perjury'thattihe in,{ornz�rr proud abmw ig urns and correct• ,
. zk
��.
�/ 9DI Date- 9l /
>IP'.hone ik
y,
t�I,�`ic we ardy. Do not mrfte in/his area,to be corapTeted by��rrto�rn ri,�'iciat
City or Town: Perraftffricense
Issuing Anthor€ty(circle one):
1.Board of Health 3.Building Department 3.City/Town Clerk 4.Electrical Iuspector S.,Plumbing 5sgettor
6.Other
Contact Person Phone#:
6 .
l afoxmatian and T-ustructious '
Massachuse#ts Gebez-A Laws chi 152 requires all employes&b Provide wa&=s'compensation fzlr their employees. .
p �{ &Bate,an�Ioye�is defined as`_.every person iu the srdvice of aaothea under any coxaract of bee,
express or implied,oral or writtco_"
Ali.errrplvyer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing eng-aged in a joint enterprise,and including the legal representatives of a.deceased employer,c r the
receiver or trustee of an individual,partv=hip,association or other legal entity,employing employees. However the
owner of a dwelling house having not mom than three apartments and who resides therein,or the occupant of the -
dweffi g house of andffier who employs persons to do make,construction or repair wow on.snch dwelling house
or on the grounds or bm'Iding appur�thereto shall not bmanse of salt employment be deeoied to be an employer."
MGL chapter 152,§25C(6)also stones that"every state or local licensing agency shall withhold tine issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
not produced acceptable evidenm of con Prance with the hw ran m cove rage required."
t who has P
a &can w P
PP P
Additionally,MGL chapter 1.52, §25C(7)states"Neither the coniu:anwealth nor jay ofits poIifiml subdivisions shall
an into any cont:act for the performance ofpublic waric u otol acceptable evidence of compli4ace with the insm-.Mce..
re cfui�ens of this chapter have been presented to the cow�¢atrfhorzty."
A.ppIiczu7b-- ,
Please fill out the workers'compensation affidavit completely,by chocking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)nam e(s), address(es)and phone numbers)along with their=t ficate(s)of
nisula ce. LimitedLiabiilityCompanies(LLC)orUmite;dLiabl7ityParfnerships(LLP)withno employees otherthanthe
members,or partner are not requ ked to carry workers'compensation insurance. If an LLC or LLP does have
affxda ' m be submitted to the D a-finent of Industrial
employees,a oIi is B e advised that this Yrt may eP
policy
Accidents for confnmation of fimn.mce coverage. Also be sure to sign and date ithe affidavit- The affidavit should
e' not the D artmeut of
be-retzlmed to the city or town that the application for the peunrt or Incense is being requested, ep
Industrial Accidents. Twuld you have any questions regarding the law or if you are regc±rd to obtain a workers'
compensation policy,please call the Department at the number lisird below. self-mmuud companies should enter their
self-insurance license number on the appropHafm line.
City or Town Officials
f -
Pleasa be sine that the affidavit is completes and primed IegibIy. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Inves6gatiens has to coact you regarding the applicant
Please'e be sure to fill in the pen of ceme number which will be used as a refinence number. In addition,an applicant
that must submit multiple permit/Rcense appliLefions m any givers year,need only submit one affidavit indicaimg r* nt
policy information Cif necessary)and under"Job she Address"the applicant should write"all locations in (citY or
town)"A copy of the affidavit that has been officially stamped or madced by the city or town may be provided to the '
applicant as proof that a valid affidavit is on file for futtu a permits or licenses A new affidavit must be{lied out each
year.Where a home owner or d zm is obtaining a license or pmmit not related tQ any business or commercial ventzu e
(i.e. a dog license or permit to bum leaves etc-)said person is NOT requited to complete,this affidavit
The Office of Investigations would Iike tD fi,ank you is advance for your coopedion and should you have any questions,
please do not hesitate to give us a call.
The Department's address,fnlephone and fax number:
Tie CQ
antti of Mnsetl s '
Department cif 1udnstial Accidents
wee r�,f�,�esfig�fia�
6()4 W n Street
=M&f 1ZF.
T( 61 -4 (',Xt 406 or 1 =MASSAFF,
Fax 9 617` 27 7749
Revised 424-07 wmae5 gugfdia
Town of Barnstable
Building Department Services
Brian Florence,CBO
Building Commissioner
g 200 Main Street, Hyannis,MA 02601
RAIMMARM
KAM www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
/ Please Print
DATE
JOB LOCATION: %9 9 Ci b y d
number strEet village
"Zloty WNW: �'��i/I
name home phow# work phone#
CURRENT MAMING ADDRESS:
dty/town state zip code
The current exemption for"homeowners"was.extended to include owner-occupied dwellings of six units or less and to allow
homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- .
family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one
home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form
acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section
109.1.1) .
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,
bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection
procedurek and requirements and that he/she will comply with said procedures and requirements.
Si (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
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:\WPFHM\FORMS\building permit&=\MRESS.doc
08/16/17
ti
Town of Barnstable
Building Department Services
HARNS AMA
� Brian Florence,CBO
�`� Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section If Using A Builder
L ,as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work authorized by this building pemut 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 of Applicant
Print Name Print Name
Date
Q:FORMS:OWNWERMISSIONPOOLS
Rer 08/16/17
Town of Barnstable Buildin
y. W11
g
PgstThis Card Soat rt; s:Visible�From the,Street :A roved Plans-M s be Retained n lob a'nd this Card N1 st be Ke
rnxr��•rww.e: z �. �. ! ��:�A �� � ;� pp��
M ted>,Until Final-Ins ection-Has'.B ad s R=Pos. p een M e:
R re`a Certificate of.Occu ane red until a Foal l;' a,I It
Permit
Whe � ,,� ,p, y is Required,.such BWldmg shall Not be Ctccup, nspect�on has been ad
Permit No. B-17-459 Applicant Name: CAPE COD INSULATION, INC Approvals
Date Issued: 03/09/2017 Current Use: Structure
Permit Type: Building-Insulation-Residential Expiration Date: 09/09/2017 Foundation:
Location: 19 SAINT CATHERINE AVE,HYANNIS Map/Lot 291 060 Zoning District: RB Sheathing:
Owner on Record: BATISTA,JUAN C Contractor�Name CAPE COD INSULATION, INC Framing: 1
Address: 19 SAINT CATHERINE AVE ,£_ Contractor License 153567 2
� ._- .�
HYANNIS, MA 02601 Est Project Cost: $4,800.00 Chimney:
Description: Weatherization Kermit Fee:
85.00 Insulation:
Project Review Req: Weatherization
z
Fee Paitl s $85.00
$ Dante' 3/9/2017 Final:
Plumbing/Gas
} Rough Plumbing:
71
„Building Official Final Plumbing: _ F
This permit shall be deemed abandoned.and invalid unless the work authorized by this permit is commenced within six months aftereissuance.
Rough Gas: .
All work authorized by this permit shall conform to the approved application and�the�approved construction documents for which this permit has been granted.
All construction,alterations and changes of use of any building and stru Lures,shall in compliance with the local zoring by laws a d codes. Final Gas:
°z
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open foripublic inspection for the entire duration of the
work until the completion of the same.
Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and FireO ff ai awls ale provided'onthispermit Service: J
Minimum of Five Call Inspections Required for All Construction Work:'
1.Foundation or Footing Rough:
2.Sheathing Inspection MM.._,... .,.. ., r,.
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed - ;, Final:
4.Wiring&Plumbing Inspections to be completed priorto Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) 'Low Voltage Rough:
6.Insulation
7:Final Inspection before Occupancy Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
Work shall not proceed until the Inspector has approved the various stages of construction. 'Final:
H "Persons contracting with unregistered contractors do not have access to the guaranty fund"(as set forth in MGL c.142A). Fire Department
Building plans are to be available on site Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
TOWN OrBA ' STABLE BUILDING PERMIT APPLICATION Q —M&i l.eA
Map ;� 1 f Parcel Application # � 1A,5
BUILDING DEPT. pp
Health Division Date Issued
Conservation Division FEB 21 2017 Application FTFIS
# 6
Planning Dept. TOWN OF�gRNSTABLEPermit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project Street Address �I r , A t(4-i
VillageAA"AVMV, L
Owner Address
Telephone b D to I 1
Permit Request V IM7 '���'! alA MGA 56 uvo
0#& &�kL (Mk� I ?A�� - -H f 091,kttl�-
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain ,, Groundwater Overlay
Project Valuation D .(� Construction Type I 4"
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family^ Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ 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 +0 If yes, site plan review #
Current Use Proposed Use
a _ APPLICANT INFORMATION
� UILDER OR HOMEOWNER)
Name Telephone Number ��l `�1 S 9 Z4
v
IR
Address W ay&(J, License # 'l0 U V
{`r Home Improvement Contractor# J
Email Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO
(4WVRA, d4�ap
ASIGNATURE DATE I I
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
a.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
4
dAS: ROUGH FINAL
a �
FINAL BUILDING
w
DATE CLOSED OUT
ASSOCIATION PLAN NO.
E . .
Town of Barnstable
�•. Regulatory' Services
��. Richard V.Scab,Director
t63y. 0
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyanais,MA 02601
www.town.barnstable.ma.os
Office: 508-862-4033 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Scction
If UsingA Builder
I, _T "1 T�X4i)S . ,as{honer of the subject property
hereby authoriz^ c�� 0' to act on my behalf,
1
in all matters relative to work authorized by this building permit applicadoa for.
f ci;,-)F C40 ,.10- Ak A cc nn,S M(1, 0 2bU 1
_ (Address of Job) "—
Pool fences and alar='are the responsilItyof the applicant..Poole
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepied_
Sigthre of Owner Sign re of Applicant
Print Nacre Print Name
oc��o�I�acv
Date
Q:r,ORMS701".lFRPERMrsSIONPOOLs ex�
Massachusetts Department of Public Safety
Board of Building Regulatlons and Standards:
License: CS•100988
Construction.Suporvisoir j =
HENRY E CAS•SIDY.�
8 SHED ROW
WEST YARMOUJH `,' •r�
.
Expiration'
Commissioner 11/11/2017 '
Y
Office of Consumer Affairs and Business Regulation
10 Park Plaza=Suite 5170
Boston, t Ma , usetts 02116
Home.Improvemeetractor Registration
Type:M1 Corporation
` 4 -_ - !0. Registration: 153567 '
Cape Cod Insulation, Inc -- nr;" 1 Expiration: 12/14/2018 -
18 Reardon Circle
So. Yarmouth, MA 02664
Aw
F A�l'�
Update Address and return card. Mark reason for change.,
scA 1 0 20M-05l11
— _ __ ...._. ._��_: � g --- '•[�-•A��,-s�s—L''!����::a!_:►�,.�;!^,Anser:2..17..i..ra,4t..r.�ar�1_.,. _
;. C-l/as�anvnwveroea�o��aaaac,/cuo®kb " i
Office of consuaisr Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only
TyA Corporation.. before the expiration date. if found return to:
Fiaell stratlon. ExRlration Office of Consumer Affairs and Business Regulation. -
.12/14/2078' t 10 Park Plaza-Suite 6170 y
Boston,MA 02116 `
Cape Cod Insul6i fir, r
Henry Cassidy
18 Reardon Ciro Y ;
So.Yarmouth,
Undersecretary a I#L a d w t si t o
f
-r.
The Corrimottweraltlt ofli USachusetts-
_ •Department of Inrlustrlr�l Accltients
1 Congress Street, Suite 100
Boston, MA 02111.2017
wWw,rt U7,gov/rlira
Workers' Compensollon Insurance Aftidavlt; Bldllders/Contractors/Electriclans/Plumbers,
Ica t Inr TO BE FILED WITH THE FERMITTING AUTHORITY,
Please Print Lc I 1)1 V
Name(Business/Organizdtion/individuaq; h �
Address: �; �L��d-•-_- ----
o
City/State/Zip G �GI �'
Phone #, �r _ F'' �,•.�'/"�' / �•'
Are you an employer?040 the appropriate box[ 7 , _
I. amaem io ar with , , Type of project(required):
t�J T P y - _,,,employees(full and/or part-time).'
2.01 am a sole proprioloror partnership and have no employees working.ibr me in � ❑New construction
any capacity.[No workers'oomp. Insurence required.) 8• '[] Remodeling
).�I am a homeowner doing all work mysoir.fNo workers'comp.Insurence roqufrod.)r w g•. ❑ Demolition
4.01 am a homoownor and will be hiring contractors to conduct all work on my property. I will 10 C] Building addition
onsure that all contractors either have workers'compensation insurance or arc solo ,proprietors with no employees. 1 l.C]Electrical repairs or additions
b
S.Q t em a genoral contractor and I have hired the sub•contraotors((sled on tho attachod shoot. 12'Q Plumbing repairs or additions
Those sub•contraotors have employees and have workers'comp.Insuranoe.l
13•[]Roof repairs
6.[3 Wo are a corportifikn and Ila officers have oxerelaod their right of exomplion per MOL o.
152,$1(4),and we have no employees.(No workers'comp.imwenco roqulrvd.) 14 ,Other-
Any gownets that submir box a I musl alto till out the soellon below showing their workors'oompansatfon Polley tnformatlon. 4,
Homeownms who subm[�this affidavit indicating thoy are doing alhwork and then hire outside contractors muaP Inror a
IContractvrs that chock this box must attached an addilfonal sheet showing the name of the sub•oonlrectors and state whether or not Ihoso entities v
amployoes. If lho subcontractors have employees,May meal ro Mo their workers' f the
, now aMdavit Indicating such.
olioy number. ha c
1 am an enployer tlsat is providthe workers'eonrponration ltrsrrrance for miy employees, Below is the polioy andob l
Injorrrratlon. f Site' �-
insurance Company Name:
Polio N
y yr Self ins. L[c.tY:�
Job Site Address: ' Expiration Date: ' r. 1.7
�
Attace a copy of the orkers' compenstition policy declarelion page(showing the pcity/statol clpaum � ___v__
Failure to secure coverage as required under MOL c. 152, §25A is a criminal violation Punishable b r•and expl tlr�a on date),
and/or one-year imprisonment, as well as civil penalties in the foil of a STOP WO p hable by a fine up to$I;S00.00'day against the violator. A copy b'f this statement may be forwarded to the Office O Inv
RK ORDER and a fine of up to$250:000--8
_ coverage verification. - esttgations of the p1A for insurance
I do hereby certify under the pains and penalties ojperJury that the lttjorntatio
n provided hove is true and correct,
Ilione
OfJlclal ase only. Dof rot write In this area, to be completed by city or town o
,/ylclat
Clty or Tetra; "
Issuing Autborl Permil/Licease t<
ty(circle one);
I. Board of Health 2, Bu[Idlog Depertrrteat.3, ty/Town Clerk 4, Electrical
6, Other Cl Inspector 5, Plumbing Inspector•
contflct Perstiat'
Phone M.
CA_ PECOD•27 DEATON
,4`coRo• CERTIFICATE OF LIABILITY INSURANCE DAT °
7/291229/2016
THIS CERTIFICATE 18 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(%AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL.INSURED,the policy(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 Ilou of such endorsements.
PRODUCER CONTACT
Rogers&Gray Insurance Agency,Inc.
434 RIO 134 no): 877 810.2166
South Dennis,MA 02660 'D E .mall@rogeregray.com
INSURER 8 AFFORDING COVERAGE NAIC d
INSURER A.Peerless Insurance Comp"
INSURED INSURERB:Safe In Company 39464
Cape Cod Insulation,Inc.. INSURER c:Endurance American Specialty Insurance Company 41718
18 Reardon Circle INSURER D:Atlentic Charter Insurance Company 44326
South Yarmouth,MA 02664 INSURER E 1
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISIONtNUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH-POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1LTR TYPE OF INSURANCE POLICY NUMBER M O .ICY EXCM
DO P LIMITS
A X COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE Q OCCUR GSP8263003 ' 04/01/2018 04I01/2017 EACH OCCURRENCE $ 1,000�000 '
$ 100,000
MED EXP one arson $ 61000
PERSONAL&ADV INJURY $ 1,000,000
GERL AGGREGATE LIMIIT.APPLIESPEP. r GENERALAGOREOATE S 2,000,000
X POLICY JECT LOC"' PRODUCTS-COMPIOPAGO $ 2,000,000
OTHER: - t
$
AUTOMOBILE LIABILITY BI ED INGL5 LIMIT , $ 1,000,000
.13
ANYAUTO 6232707COM01 04/01/2010 04/01/2017 BODILY INJURY(Per peracn) $
ALL OWNED
AUTOS AO ', BODILY INJURY(Per accident) $
X HIRED AUTOS X NON-OWNED
AUTOS d $
X UMBRELLA LIAR X OCCUR $
C EXCESS CLAIMS-MADE EXC10006636001 04/01/2016 04101I201T EACH OCCURRENCE S 2,000,000
AGGREGATE S-
DED X RETENTIONS 10,000 Aggregate $ 2,000,000 f
WORKERS COMPENSATION
AND EMPLOYERS,LIABILITY T .D OFFICEROMIEMBEREAXCLUDED ECUTIVE Y�'NIA CE00431902 08130/2018 0813012017 E.L.EACH ACCIDENT M $ 11000,000
(Mandatory In NH)
If yaa,deawibe under E.L.DISEASE-EA EMPLOYE $ 11000,000
DE CRIPTION OF OPERATIONS below E.L.DISEASE•POLICY UMR $ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached it more,pave 1s required)
Workers Compensation includes Officers or Proprietors.
Additional Insured status is provided under the Genera(Liability and Auto Liability when required by written contract or agreement with the Certificate Holder.
CLEAResult,Eversource and National Grid are listed ae Additional Insureds on this p6ilcyon a primary,non-contributory'eels.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS. _
.m AUTHORIZED REPRESENTATIVE x
®1988.2014 ACORO CORPORATION.' All rinhlA ranarvad
°Fig ram,
The Town of Barnstable
a s
+ SARNSTABL$ •
Office of Community and Economic Development
230 South Street
Hyannis,MA 02601
Kevin Shea Office: 508-862-4678
Bisector Fax: 508-862-4782
February 2,2005
Mr.John C.Klimm,Town Manager
Gary R Brown,Town Council President
Barnstable Town Hall
367 Main Street
Hyannis,MA 02601
Re: Johanna Cog e; shall- 65 Marsh Lane,Hyannis- a single-family accessory unit
Debra Samia- 324 Nye Road, Centerville- a single-family accessory unit
Stephen Duff- 1586 Hyannis Road,Barnstable- a single-family accessory unit
David Kennedy-.19 Saint Catherine Avenue,Hyannis- a single-family accessory unit
Daphne Clark-244 Patriot Way, Centerville- a single-family accessory unit
Sandyl enney- 25 Newton Street,Hyannis- a single-family accessory unit
ohn Kent- 464 Oakland Road,Hyannis- a single-family accessory unit
Gentlemen:
This letter is to inform you that the Accessory Affordable Housing (Amnesty] Program has received
requests for project eligibilityletters under the.Community Development Block Grant (CDBG)
Fund and under the General Ordinances of the Town of Barnstable,Article LXV-Pre-existing&
Unpermitted Dwellings and the Criteria for the Local Chapter 40B Program.
The Program Coordinator is reviewing the requests.If the Town has any comments on the projects,
please forward them to me so that they can be addressed in the site approval letter.. This letter gives
you official notice of our receipt of the above application(s). We will issue a decision as to the
acceptability of the sites and the consistency of this development within the guidelines of CDBG.
Sinc rely
Kevin Shea,Director - -
Community&Economic Development
cc: Town Attorney's Office
Building Department
Public Health Department
Assessor's map and lot number
/� ref T E
Sewage 'Permit number `i/�
t ° l BAUSTADLE i
House number' .......:.........................:............... .... ... ...... s� N"
a
0 VAR a.
TORN ;OF BARNSTABLE••
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ... .. � �d(.�. .. �..; ... ......... ...... ............................................ ................
f ....
TYPE OF CONSTRUCTION ... .. .. Cij �l! ..4..................................................................
................19Q.
.,_
TO THE INSPECTOR OF BUILDINGS:
The undersignee�d'hereby" applies for a permit according to the following information:
Location, .....�." -E... '�l..t ?. _ .........:..............................
ProposedUse ...,... ... r�. ...............4.`, ..6;E.......... ..............................................................
Zoning District ............k6..................................................Fire District ... ...... ........., .........................................
Name of Owner .. .a.. .a ..6-%LP_,. A/.........Address P� ..... .�..�� F.`��......v P.:.
Name of Builder' (`.1...V�- ` .Iff :.............Address it ��ir"p��.��...� ��` :`waa .
?..
Nameof Architect ....:.............................:...............................Address ............................:.....................................................:. ,
Numberof Rooms .................................. .....................Foundation ..............................................................................
Exterior ..1. . ...........................................................Roofing .. ......Q.- - ................................................... .
Floors .... 4( .. .............................................Interior ...... r . � ..............................................
' Heating .................................:.................:..................:...........Plumbing ...........: :.....
Fireplace .................................. . ............................. .........Approximate Cost .........I'— .............................
Definitive Plan Approved by Planning Board: ___________— _ •,.. '
. ........... . . .......:...........
O°
Diagram of Lot.and Building with Dimensions Fee
SUBJECT, TO APPROVAL OF.bOARD OF HEALTH,
JX
-32
----------------
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above .
• construction. • .` e ��
Name ....... . . . ..... ....a... ................
GERSTEIN, CLAIRE
No � ..... . Permit ADDITION
...... it for ....................................
..
Sin
Family Dwelling
..... ...............;.................................
19 St. Catherine Street
Location ................................................................
.............. ...H.v.an...n...i;.1.s..........Claire Gers teine Owner ......... ... 11..................................
A
Frame'
Type'6f Construction ...........................................
...............................................................................
Plot .... ........... ........... Lot ................................
October.. 26 83 ILA
Permit Granted ..................... ............19
or
Datex-of drispection ........................... .......19
Date` Completed ......I
Assessor's map and lot number r -
r f `'f 'THE
.' �Q� r
'Sewage Permit number
Z 123 STABL i
House number ....... rasa
039,
E M Or.
TOWN - OF IBARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO 65 � C•�/�I pad.
... ..... .............. .........................................................................
/t.? t
TYPE OF CONSTRUCTION ...1. 1 ...ram. "4 �N t� .......................
................................................ .
TO THE INSPECTOR OF BUILDINGS:
The .undersigned hereb]y� applies .for a permit according to the .following information:
Location ..... / • (/ /t/ G� ,s
it�.� .... sue.Proposed Use ....... .. 3.... . ....................:...... ......,.... ... .../..:j............:................... :..........
Zoning District ................. .�,?..... ... .... ............... ........Fire District ... ;'`: ' ..? ` ...............
Name of Owner . .. !t{.! ....�� .��7C;.I a. ....Address .... .....��I�`��.�. .... ..........
Name of Builder- .k. ... C .. ..... .Address .. �. ................� .' ..
l
Nameof Architect ........................................................ ........Address .................... :. .............................. ............................
Numberof Rooms ........!................................................... ..Foundation.... .....................................................................:........
Exierior .. >T ..........................................................:Roofing ........flt' i . .?................................................. ...
Floors .... ... . .................. ......Interior ...... ... . ...............................................
Heating .......................................................... .....................Plumbing
Fireplace ... ..................................................................... ......Approximate Cost...,., ... QC�`...............................
Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ..........................................
f'f)
Diagram of Lot and Building with Dimensions Fee �....................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
,A
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS t
I hereby-agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ..... .d ...... r ........... ..................................
GERSTEIN, CLAIRE A=291-060
/-5689 ADDITION
No ................. Permit for ....................................
Single Family Dwelling
...............................................................................
Location 19 St: Catherine Street
Hyannis
............................................................................... .
Owner Claire Gersteine
..................................................................
Type of Construction .....Frame
.....................................
...............................................................................
Plot ......................... .. Lot ................................
Permit Granted „October 26, 19 83
Date of Inspection ....................................19
Date Completed ......................................19
1
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