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HomeMy WebLinkAbout0019 SEATERN WAY wy oil �� �o�• ��� .. �� / i� �-- A 4 Town of Barnstable wilding �Post,This;�Card SoThat 1t is"Visible Fromthe.Street-ApprovedsPlans Must be-Retamed:on Job and;this Card Must,be Kept MAS&wets s Postied Unfil'Finallns ect on Has Been 11%latlek • WhereaCert�fi�cate of Ocpancys Requiredueh Bung-shall Notb Occupied until a Finallnspeciha�been made e1 ii�l Permit No. B-20-400 Applicant Name: Approvals Date Issued: 03/02/2020 Current Use: Structure Permit Type: Building-Deck Expiration Date: 09/02/2020 Foundation: ' Location: 19 SEATERN WAY, HYANNIS Map/Lot 251-251 Zoning District: RC-1 Sheathing: be = s•, '-w+aw . Owner on Record: MONTERO,JORGE:R&.BESSY t Contractor Name: Framing: 1 Address: 19 SEATERN WAY ) Contractor License 2 HYANNIS, MA 02601 Est Protect Cost: $5,000:00 Chimney: 4 ; e Permit Fee: $ 110.00 Description: REPLACE EXISTING DECK ; Insulation: Fee P aid: $ 110.00 Project Review Req: .3/2/2020 Final: Plumbing/Gas .: Building Official Rough Plumbing: ._ s This permit shall be deemed abandoned and invalid unless the work author¢efty this permit is commenced within six months after,issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application'4the'approved construction documents'for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zonmgby laws and codes. This permit shall be displayed in a location clearly visible from access sheet or road-and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same a 146 31 `Electrical The Certificate of Occupancy will not be issued until all applicable sigures by the Building and FireOffaals a e3pro ded on this permit. nat s Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection g 3.All Fireplaces must be inspected at the throat level before firest flue'lining'is"installed"°'" " 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation -Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (asset forth in MGL c.142A). Final Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT ISSUED RECIPIENT Final: Application Number.... COO................................................... FEB 1 MASS. TOVVIV Permit Fee... .. .. ..................Other Fee........................ 039. BUILDINV".% nep- Total Fee Paid............................................................... ...... ................o TOWN OF BARNSf ft- VIV-020 Permit Approval by.... n3 v4... TVVJ,q Tvi- BUILDING PEORMI Map . ......... ......... Yarcel...... .................................. APPLICATION Section 1 OwnWs Information and Project Location MAR 0 3 2020 Pro jectAddress- S��Tet �X W OL Village 11 Owners Name k)-4m Owners Legal Address City State zip Owners Cell# 5-0 6 5 E-maiI h' M C>Sn-0t Section 2 —Use of Structure Use Group F-1 Commercial Structure over 35,000 cubic feet Commercial Structure under 35,060 cubic feet Single/Two Family Dwelling , �Section 3 — Type of Permit ❑ New Construction ❑ i'Move/Relocate E] Accessory Structure ❑ Change of use ❑ Y, Demo/(entire structure) El Finish Basement El Family/Amnesty El Fire Alarm Rebuild EI—Deck Q�P4 0 WVTApartment El Sprinkler System F-1 Addition F Retaining wall E] Solar El Renovation ❑ Pool El insulation Other-Specify, Section 4 - Work Description Last undated: 11/15/201 R Application Number.................................................... Section 5—Detail Cost of Proposed Construction 4P d00 Square Footage of Project a7 SF Age of Structure "" Dig Safe Number r-; # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom i Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 The Commonwealth of Massachusetts Department of lndushWAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers . Applicant Information Please Print Lezibly rg Name(Business/Oanizason/individual)' n\"q 0 T,t' Ot2�_ Y'0 Address S_eA. 11 City/State/Zip: h MLQ I Phone#:. S-0P �3 - a }- , Are you an employer?theck the appropriate box: " Type of project(required). 1.❑ I am a employer with- 4. ❑ I am a general contractor and I employees(full and/or part-time).* Have hired the sub-contractors 6. []New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for mein any capacity.acitY• employees and have workers' Z 9.'El Building addition [No workers' comp.insurance gyp•insurance. .A1 . - 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3�am a homeowner doing all work officers have exercised their 11.❑PIumbing repairs or additions m sel£ o workers'comp. right of exemption per MGL' y [N p 12.❑Roof repairs insurance ]t c152,§1(4),and we have no 13`�] � rzClC p CQ `1 employees.[No workers'. 1 comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating suck xContractors that check this box must attached an additional sheet showing the name of the sub contractors and state whether or not those entities have employees. If the sub-contmaors have employees,they must provide their workers'comp.policy number. lam an employer that isproviding workers'compensation insurance for my employees Below is thepolicy andjob site information. Insurance Company Name:' Policy#or Self-ins.Lic,#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy.number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may he forwarded to the Office of Investigations of the DIA for irisurar,ce coverage verification. I do hereby certify u der the ptd p o that the information provided above is due and correct Signature: Date: Phone#: Of)7dal use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): C> =� 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5:Plumbing Inspector 6.Other Contact Person: Phone M Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person id the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an mdividual,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 maintensace,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance'with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for conformation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should 4 be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out 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. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to buns leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hlce to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of In&sbW Accidents Office of Investigations 600 Washington Street Boston,MA 021.11 Tel.#617-727-4900 ext 406 or 1-877 MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia � �yV\ �, '1 BUILDING DEPT. ; MAR 0 2 2020 GOWN OF BARNSTABLE /� p ® � p o ® J y SCANNED r V RQ'3202 Ai wee.. w._..r+•�-.a, pi LAM V))E CA 0tE-Q L n N[M Application Number... ....... ..... ... ..... .. Section 9- Construction Supervisor Name Telephone Number Address City State• Zip License Number License Type , Expiration Date Contractors Email . Cell I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code.,_I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable:Attach a copy of your license. Signature Date Section 10-Home Improvement Contractor. . _ i . Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your HJ.C... Signature Date ==::::-Sectionll Home Owners License-Exemption Home Owners Name: LTelephone-Nuniber S1 'Cell-or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the of Barnstable. $ Signature APPLICANT SIGNATURE Signature Date Print Name S13 11�3 ro Telephone Number 1�o �R E-mail permit to: �'o `1,e r"0)1 ke Yb `-F L" s-,CA6 a n('it Last undated_ 11/15/201 R 1 Section 12 —Department Sign-Offs ' Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) i Signature of Owner date Print Name -i C x r 1 Last updated: 11/15/2018 7( .�" ro i w. S,''�n Y'S?,i 'i#6'it1',�t {iG*7":Yt'.xH .�'A"��#Ri`� ^'2:,'�,.:nv. �+W*y„r..w ,pr+asr'y!-+, Y i5 Y• a Cft.;,.,,�r.,. R ..'+1W4` I „". r,.-s^ d r- t f stt-.3 F•4v a;' .:a l,.f t r. 1 ""�'xm a {ry(-A pFINC TOWN OF BARNSTABLE Permit Wo;, 31.020 BUILDING DEPARTMENT Cash .... TOWN OFFICE BUILDING HYANNIS,MASS.02601. Borid x CERTIFICATE OF USE AND OCC SUPAN COY a tir Issued to C ]C CO a1 Roa y ` ru >t Address -Lo-c .4flSy 19 . ``o'ea:tcrZt bJA 7 USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT-BE•YAL,ID, AND.THE BUILDING SHALL NOT BE'OCCUPIED•.UNTIL. SIGNED BY .`THE BUILDING ,,INSPECTAR :UPON•SATISFACTR OY-COMPLIANCE WITH TOWN REQUIREMENTS AND 1N ACCORDANCE WITH SECTION-119:0 OF,THE,MASSACHUSETTS STATE BUILDING CODE. �--- Building.Insoector.. ' �J a`�y��•'. TOWN OF BARNSTABLE BUILDING DEPARTMENT 2 aseaaraIM :MYL TOWN OFFICE BUILDING i6J9• HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: 2/ d C. '� /9 d"-—7 An Occupancy Permit has been issued for the building authorized by BuildingPermit #. D ._...._............................................................................................. .............._.........................»............ issued tosa��� Co�d..... j�.......! r...........1,�/•_l ._...... ��..�.� l�/'.r/ f. �.. Please release the performance bond. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) M A = / L DATA TOWN OF BARNSTABLE, MASSACHUSETTS BUILDING PERMIT ci-Z�'�L—UU3 . J U. f 2 fit f3'i )DATE — 19 PERMIT N�F �Y . '....;ii i...+..ii. ._ [8*�V i C�� �'i=...t:fz:1L'i_i i:.. '�': il•:.^�7:1: APPLICANT ADDRESS (NO.) (STREET) . (CONTR'S LICENSE) .Juil.CG C--l-A_ L.L11.�.'- iY :?a.:'• ' c'„ .. :.;i yr.:.i. . NUMBER OF t PERMIT TO STORY 'i'?�'' DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) C ZONING AT (LOCATION) Y,ci'y; i:.., D STR CT L' IN0.) (STREET) BETWEEN AND (CROSS STREET) (CROSS:)ST.REET) LOT SUBDIVISION LO7 BLOCK SIZE =5 y BUILDING IS TO BE -" FT. WIDE BY - FT. LONG BY FT. IN HEIGHT AND SHALL�CONFORM IN CONSTRUCTION •i ti' TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION p (TYPE) .. t, REMARKS: t AREA OR ! j ii: , PER UME .Lt. _ ESTIMATED COST `ref p .Iti FEEMIT (CUBIC/SQUARE FEET) DOWNER - BUILDING DEPT. r ADDRESS _ , f_ I, BY I+ THIS PERMIT CONVEY b TO'O^'C U'P'YA ANY.?'ST REET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENT P C_40PERTY NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICI ON.�S,T. EKT ,,ALLEY GRADES AS WELL AS DEPTH AND.LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF, LI'PUBC`W 'T E„ISSUANCE-:OF-THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF.ANY'APPLI ABLE.SUBDIVISION RE S TR IC-ION S.'? + 'MINIMUM OF 's-T.REE CALL - APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE •ifNSPECTIONS"-RE'QUIRED-FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL'.CONSTRU,C.T P.ON WORK: ELECTRICAL, PLUMBING AND `4 FOUNDATIONS OR FOOTINGS'-. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. PRIOR TO;''COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL AaEM__L INSPECTION TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE .00 C U P A N C Y7--j - - V POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 14 1 1 RIK 1 z z f ---�%-= z 7 3 HEATING INSPECTION APPQ&ALS ENGINEERING DEPARTN4U'L OTHER BOARD OF HEALTH MUST CONNECT TO TOWN SEWER WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN Bk TOR HA$sAPPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION, PERMIT iS ISSUED AS NOTED A'.•)VE. NOTIFICATION, b r . Assessor's map and lot num r oFI"Ero 'Sewage Permit number f.P ... . . . . �-/ _ Z .BJBB9TADLE, i House number ............... .�`?...... ..'�.:..........r........:..........; 9�0 6 9a\e�, { O MPY BARNS�ABLE TOWN, OF BV11DING INSPECTOR s APPLICATI Construct Single Family -Dwelling ONFOR PERMIT TO .... ........................................................ ..... ........•..e..>.....,:.,.. .,,...... .......:.:...... L Wood Frame y TYPE OF CONSTRUCTION `.......... ........ ........i..1.......... � September��6 �1985 .... ........... ; x .... TO,THE INSPECTOR OF BUILDINGS:, } ` The undersigned hereby applies'-for a permit according to the following information; I Location Lot..#,..7. .Sea .xn..Play... .............:................................ .... .................................... - IT - - Proposed Use ....... ................................................. . ................................ ................................ j I, Zoning, District..C...j .............................. ,,.,,Fire District H}ranni8 Name of Ovvnea�ricc�rn Ralty.- TX'u8;t°::::........Address7b : 'alIDOli��—jQ:1C.�.: Tf,�I�Y)j,fJ�-::M3g8.• Name of Buitd r821C.....Re ...Est..DeV.CO. Ino•-.Address ...........SM.Q.................................... {<s Nameof Architect ..................................................................Address ..................:..:.........................................:....... ............ 41 . Number of Rooms S .X ........Foundation' 'R.................. Clapboard -an or---Shin es;; ......Roofng ...........Asptal- t.:.StiIglQ8.. ..........:.....:.� ..... ;-� Floors C Interior ...........Se.BtrCG:.,. ............,:..................... ...... r Heating Gas.......:.....F.W.A.................'.........:...: -......,.............Plumbing .........TWO...... -......Gopper... .............................. Q 'FireplacOrie $Q,.QOQ Q.Q,,,,,,,.,,,........ ................................................:....................Approximate Cost a. Definitive Plan Approved by Planning Board --------------------------------19--------. Area f t,.......: .. Diagra%m of Lot and Building with Dimensions Fee �f i.. .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH AJP , v, off � •. . . , Lk s , OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all.the Rules and Regulations the Town of Barnstable regarding the above construction. Name Preis..'... Construction Supervisor's License . . .................. onog8�9 �� r1 r CAPRZCORN REALTY TRUST N� Permit for .....12....Story......... ..................................g� ' jjg�,!:�..)�amilv Dwellin Location .....Lot #18 , 19 Sedtern. Way ........... ...... 3 ] .yannis .............................. .............................................. -'Owner .......C:ap.r.icorn Realty Trust ................................................ Type of Construction .......Fr........ame.................... .... . ...................:..................................................:.......... Plot ............................... Lot ... ............................ July 24 , 87, Permit Granted ........................................19 Date of Inspection. ................... . ...... 19 Date Cornp�etecl ........ .............19 !t Assessors map and lot number :,. ...... rvs ` y�f TN E Sewage Permit number .. ..:..... BAB39TABLE, i a House number ............. t.L..�. ..... ........ .:.......:................... NAM 39' � 'Fp MA-4 M1 -TOWN OF . BARNSTABLE , BUILDING INSPECTOR —A P ��e �am�l )wetlin � APPLICATION FOR PERMIT TQ-"" TYPE OF-CONSTRUCTION ...wood Frame.......................................................... ......................................... �a September ; G_ 1985 .=,, .............. i ........ TO .THE INSPECTOR OF BUILDINGS: - The undersigned hereby applies for a permit according to the following information: .f , i Location Lo.t.....,..... 1 3:'•S.oat.ern..Iday...11y.aiin.iz...1 A..........................:.................................::....................................... fProposed Use ........................................................ ........ ...... . ................. .................................. .............................. Zoning Districf C... :.. ............................... ...............................................................Fire District ..Hy gm Name of OwPr,4P.ricorn„Real�y...�xu�t..................Addreas6, ..k'�]mo�1t. ..Ro.ad.,...H,}�ar111S,s{.,....ilcia$gY - Name of, BU CO..R.e�..ESt.Dev.Co,..,.1n¢.,.....Address .. .....Same...............................:... ............................... Name of Architect Address i Nomber.of Rooms SAX ....................Foundation ..P..0..................................................................... Ala board an o S„i Exterko ....�..............:......... .....�..... ... .fl.>�.....................Roofing .......A.SprlSlt••,$h1T;rgle.$................................. Car @t Floors ?............................................................. Interior .......Sheetrack.................................................... � -{ aa:.... F.W.A. Plumbing rieatir ............................................. g .....TWa.............CGRPer...................................... Firepld �ne --- ...Approximate roximate. Cost !0. 00.0 00 Q.................... /. t Definitive Plan Approved by Planning Board ---------------------------------19--------. Are4.0.-.5E6!.s .• f. - ........... 1 Diagram of. Lot and Building with Dimensions C...•. g g Fee .. ,,- ...............'................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ��� s p , r �> OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS i I hereby agree to conform to all the Rules and Regulations Q.f, the Town of Barnstable regarding the above construction. Name ...... C? . .. ....... ' a rea. r � i f � � Y Construction Supervisor's License .................................... 000989 CAPRICORN REALTY TRUST A=2724003 ` 5 OT No 31020 permit for ..................1 Story ................ ................. b Single Family Dwelling ............................................................................... Location ......Lot #18 , 19 Seatern Way ......................................................... Hyannis .....................................................................:......... Owner ...........Capricorn Realty Trust ...................................................... Type of Construction ....Frame ................................................................................ Plot ............................ Lot ................................ Permit Granted ...July.. 2.4..................19 87 Date of Inspection ....................................19 Date Completed ......................................19 , ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �GL2i Map �. S ZS-/ Parcel Permit# 70 97 Health Division �l®3 �l D� Date Issued 2 0 Conservation Division 103 Application Fee Tax Collector Permit Fee Treasurer APMCANT MUST OBTAIN A RrER Planning Dept. CONNECTION PERMIT FROM TIIE ENGINEERING JEOB TO Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village ir, Owner z, � Address Telephone a ? Permit Request ®o /Z - 41 IC/ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuationg-2-a oo, 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 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 2 new Total Room Count(not including baths): existing & new / First Floor Room Count Heat Type and Fuel: &r6as ❑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 &Kew size Other: . Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current-Use `Proposed Use BUILDER INFORMATION Name Telephone Number _� -o L4 1- o L; `� 9 Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO - SIGNATURE i y-L-G� i� DATE - -Z�� �'3 I� 2 ti FOR OFFICIAL USE ONLY .ri PEQ IT NO. DATE ISSUED f • , MAP/PARCEL NO. Y v� ADDRESS - VILLAGE T OWNER ' DATE OF INSPECTION: FOUNDATION . FRAME r INSULATION i �? FIREPLACE ELECTRICAL: ROUGH FINAL' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' ! r FINAL BUILDING - DATE CLOSED OUT - ! ASSOCIATION PLAN NO. Y' The Corrimonwettlth of�lrassachusetts - =- Department of Industrial Accidents esff atiaas alf ed aflQY 9 600 Washington Street Boston,Mass. 02111 'Workers' Com ensation In-sur'ance�idavit ,21 MIK FMII %/ name. a ................... location: �''""�"" hone# 2' ci erforming all work myself. 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'S`Yv'f7:�{S'f+y:}'?`fGrGf{:;ih:S<`r,'•?::�fi}iv kr•:).:,x;{<r,'�?'•:..•4Yf:r}E4,r'R{2:.{, •y::i{v}f:.}•x•...,.:.R{` QLL(r�•'Yf' �} ,v .,.:.}i:•'•?;:?�`'?r.rr• ;;:,,x.4�?rr�R.a,st• •f.• ` r{:+.x :;.a.:z;?.{u•:•x�,c.:;•Gi.�••:: fC.$}.t}\{;f4'G,:?:d:iffi`•::Y!.:,?{.}ry4f'b>,.�•�,'fi)��:`tiG�C3.f;,:!::a}•:f:S ..•:r:.{,.}}:+:..., ?`/ "` ositlon. erirninalpenaltiesofa$aevtptoS1,500•�mdlor Fx t to secore coverage as required under Section 25A o[MGL TO wORK ORDER and lend to the 1mP a doe of$100.00 a day agate me. Iund° �that a one years'imp�oT�tmd as wen as civff penalties in the form of a STOP W copy of this statementmay be forfrarded to the OfB.ce of Invesiigatians of the DIA far coverage verii[caiion. under the airs and penalties"of perjury that the infonnation provided above is true anti correct I doh hereby certify P Date signature ?how �9 � coo Print name official use only do not write in this area to be completed by city or town official C2Buaiilng Departzneut per rdt/1'cense# OI,icuWng Board city or town: ❑sele:ctmen's Office ❑ �kif�te late mponse is required ........ .. phone ❑$eal�Dep contact person: • e e Information and Instructions Massachusetts General Laws chapter�152 section 25 requires all employers to provide workers' compensation for their is defined as every person in the service of another under any contract oted from the 'law", an employee employees. As qu . 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 o another who employs persons to do maintenance, construction or repair dwelling wouse or on the grounds or be deemed to be an building appurtenant thereto shall not because of such employmentemployer. 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,neitherthe 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 conftwting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situmtionand dying 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/hcensa number which will be used as a reference number. The affidavits may be returned to or FAX unless other arrangements have been made. the Department by mail 'The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please edo not hesitate to give us a call. .�Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents amce of Investlgauans 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 • I i\ Town of Barnstable Regulatory Services S Director - IX, Thomas F.Geiler, 9$ i6z9• ��� Building Division prED MPi A . Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 2-4038 Office: 508 86 Fax: 508-790-6230, Permit no Date D 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 CostP'L e Address of Work: 1 9 Qa - L/ Owner's Name: aD ^� OL Date of Application:_- X' I I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 0�ding not owner-occupied uOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MUROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c, 142A. r SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. a; OR n,+P Owner's Name MSIDENTI� BUILDING PERMIT` FEES ' APPLICATION F'EE � $50.00 _ New Buildings,Additions $50.00 Alterations/Renovations Building Permit Amendment $25.00 FEE VALUE wo MMET NEW DYING SPACE x.0031= square feet x$96/sq.foot= / plus f370m,below(if applicable) .,TEgATIONS/1tENOVATIONS OF EXISTING SPACE = 3 f�� g°C " ' square feet S64/sq.foot= x.0031 plus from below(if applicable) ACCESSORY STRUCTIIRE>120 sq."I >120 sf-500 sf $35.00 >500 sf-750 sf 00 75 >750 sf-1000 sf .00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building pit x.0031= square feet x$961sq.foot= STAND ALONE PERMITS x$30.00= Open Porch (number) p x$30.00= Deck (number) x$25.00= ' Fireplace/Chimney (number) ., Pool $60.00 ng Inground Swimmi Above Gr ound ound Swimming Pool S25A0 S150.00 RelocationlMoving 7 /G (plus above if applicable) Permit Fee Town of Barnstable Op1HE Tp�,_ Regulatory Services enxxsrnBLE, ; Thomas F.Geiler,Director 9g, _' : .�� Building Division �Eo bra Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: $— 1 - O 3 JOB LOCATION:. number street village "HOMEOWNER!': KV to name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building_permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. 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 H eowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use m your community. Q:fomu:homeexempt r °p'THE r Town of Barnstable P Regulatory Services BARNASS. # Thomas F.'Geiler,Director i639, 9�A ,��, TE039 A Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 February 27, 2003 Mr. Frank Liseno 19 Seatern Way Hyannis, MA 02601 RE: 19 Seatern Way Dear Mr. Liseno, A complaint has been made regarding a refrigerator on your property that has been there for a number of weeks. This is a serious safety situation. The doors cannot be left on the . unit. The refrigerator is also detrimental and objectionable to the neighborhood. . Please contact me at 508-862-4033 as soon as possible to rectify this situation. Sincerely, q , KJ David Mattos Building Inspector y � i d L I *4 xv. :: � �..r.+r•R .h. �"�,� y-. �°�,tl+� .� r*dam ""�,k"- � �.,K � ���F �'"�°y,T`�7',��"`t '� �i. 'u* �, 3 P'r ��Ar. A',^ ;�Nw We rt+.'. Rc �n w'-"' °""' - ,�7* ,.•Y" Y ,.�, "j T vr. w,. ov ll N TA .�'"}*r"• .. ..,, � r�. sq,.t+' "r '��a,� a +w., C� r- i ,y...;� i Y 1, • a asA ,AA, lff"M MA 'I FAT ++w+ 's:`...,:,, !�a����+1 t .,itf :' r• �f�r'4` * �` 'a�-y,..~ �j�� h *'�` ii dy'�`�!A'Ek/��{d���� �._ ��yq��/�ro;, 74 Alt RfM- 14 k ;FW 04 ta'! J 22m, tam rb Vw 79", Town of Barnstable ��.*114E'°'�tio Regulatory Services " Thomas F.Geiler,Director EARNSTABM « 9 � . g Building Division s63q• PIED NIA'1 A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 y Fax: 508-790-6230 Office: 508-862-4038 PERMIT# 6 Z FEE: $ SHED REGISTRATION 120 square feet or less Location of shed(address) illageColl . Pro rty er's name "Teleph number � 2 Size of Shed Map/Parcel# { L Date �gnat�ur Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE . COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE, PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 ------------- - � tom\ !L `r N E RTY I-I ES A&MY RA E STANDARD LEGEND NOTE:not all symbols will appear on a map GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES EDGE OF BRUSH _—' ORCHARD OR NURSERY V-7—"7—V EDGE OF CONIFEROUS TREES ---d t MARSH AREA —~ --- EDGE OF WATER __= DIRT ROAD 1 ° / DRIVEWAY a I �—PARKING LOT I ��PAVED ROAD -- -- DRAINAGE DITCH r� ————— PATH/TRAIL PARCEL LINE** y MAP)to -c—MAP# 8 s1 2 21--E—PARCEL NUMBER u° � ° \ #te5o E HOUSE NUMBER /—` / \ {�--/l 5 2 FOOT CONTOUR LINE s 10 FOOT CONTOUR LINE 19 Elevation based on NGVD29 k 4.9 SPOT ELEVATION / \ � � /• STONE WALL -X X FENCE RETAINING WALL RAIL ROAD TRACK f STONE JETTY \ / SWIMMING POOL ""' PORCH/DECK 0 BUILDING/STRUCTURE L P+FL DOCK/PIER HYDRANT ko 6 VALVE ® MANHOLE O POST (37 FLAG POLE `• T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N 1 T 0 SIGN ® STORM DRAIN w PRINTED SCALE IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representation DATA SOURCES: Planimefria(man-made features)were interpreted from 1995 aerial photographs by The James 1"=100'smle mop and may NOT meet of ra boundaries.The are not true locations,and W.Sewall Company.Topographyand etation were interpreted from 1989 aerialphotographs b GEOD UTILITY POLE n TOWER w ° National Ma Accuracy Standards at this P y P Y 9 �, 20 ' t4U P ry do not represent actual relationships to physical objects Corporation. Planimefria,topography,and vegetation were mapped to meet National Map Accurary Standards 4 LIGHT POLE O ELECTRIC BOX : t INCH=40 FEET* enlarged scale. on the map. at a scale of 1"=100'. Parcel lines were digitized from FY2003 Town of Barnstable Assessofs tax maps. P:\dgn\conservationAgn 08/01/03 04:16:34 PM yp„ol_ _ t i si- 'i /•'. ,n 1.:� kAta� �'��' `�:.,� v: .e ..ti asT -�`� Y'* �. ��W:' Icy '.• �x�l..+�xi w :y �� � •c.� ' r �.'��y♦ 'i�t-� 3'� �,a�r ,�~ �.� „, . .,�' 3 .x,;.�. .,� � tR;. _ x• at ?'� tt -'' �:�f., +r •,.it. +.r,.' .:z j a., .` y• `� + y�.-;u,.;�Z: y„ ,� s':-gay`� 'rt�; .2•:¢: "el �?{�`)y?•T a,Lai ,,,-`-_•`.7��♦♦ �.'.e1•y �,r'I'�{' •�.4�4, •�v��yp9f✓�� A f(•a 'ice' (• 'Y� _ '� �. 7t� 1 Yi.8. • �, .� '$ .. i + }�` _M.v�• ��.•4+ �.. \� '.�� •'�•i,'. ,•� iv P' - ` t f_'bjPi .x. 'tr^ L's •- r Rf tt.. ' , Q�fc..•1• ♦•��D 4.'v ,i.��"?. /"•L s?�� ••: •�.v x[y[$u�,� � —'..x,ti•%r �' 't: �• st v r�'�_t'yt� •y•� .-o- .7'S>t."' ,s� '�.."^y�r �,. 1 •+. l�^ t 4'�' .Y:4r.. 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WATER SYSTEM OKH? # BEDROOMS ZBA DECISION FAMILY APT } LOT SIZE 14810 .4 OPER/MGR NAME WET LANDS MULT ADDRESS USE 101 PROTECT DIST GP (N) EXT / (P) REVIOUS / NO M ES / PER(M) ITS / (V) IOLATIONS / (G) EOBASE / (E)XIT NO MATCHING RECORDS FOUND 6/1- Cr Ole- U - A Parcel Detail -- Page 1 of 3 .�� .��, i _fry¢ "�: � � _ ��� �. ,,�scj/�Ssp{ •4C,�yy €T L% y 09 Logged In As: Thursday, August 20 2009 Debi Barrows Parcel De ail a Parcel Looku Parcel Info _ -- _ Parcel ID251-25 Developer LOT 18 Lot��...�..�_.__., Location,19 SEATERN WAY Pri Fro tage Z I -- - Sec , Sec Road i Frontage Village HYANNIS Fire Distric I ANNIS Sewer Acct 2903 _ Road Index 2098 ._ ..w_ .._ .. V ok Interactive ;,c a Map t c Owner Info r IMONTERO, JORGE R & BESSY J - -_ Co ne Stre t1 19 S RN WAY _ �.____%_____—I re �- City jHYANNIS state 1022 Country Land Info Acres 0.34 Use Smgle Fam MDL 01 oning RC 1 ghbd ( 1 __........ _...__ . _. _... . Topography l Road Utilities Location Construction Info Building 1 of._l.._ -. �_ _.m,.. ., Year�m Roof' � xt 1988 i � 'n ie `e Built{ �Struct p j g EArea 2097 Rof Cower jAsph/F tlGls mp. Ac( one r r �o i Int d "m style Cape Cod I Wan;�ryW I R oms 13 ooms Model 1Residential I Floor _w- R s l Full + 1- _ Grade jAverage Type HO A IRooms 7 oms http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=18600 8/20/2009 Parcel Detail Page 2 of 3 x. Heat r .. . Found- ; ... ... _..... �� 6a Stories i1 1/2 Stories Fuel lGas ation ipoured Conc. �E G °.a Permit History Issue Date Purpose Permit# Amount Insp Date Comments 08/20/2003 Remodel/Renov 70946 $2,000 11/02/2004 00:00:00 08/01/2003 Out Building 70702 06/07/2004 00:00:00 07/01/1987 1 B31020 $40,000 01/15/1988 00:00:00 1 HY 11/2 S Visit History Date Who Purpose 11/02/2004 00:00:00 Martin Flynn Bldg Permit Completed 06/07/2004 00:00:00 Martin Flynn Call Back Next 11/13/2002 00:00:00 Paul Talbot Meas/Est 06/12/2002 00:00:00 Paul Talbot Meas/Listed-Interior Access 07/15/1990 00:00:00 ML - Sales History Line Sale Date Owner Book/Page Sale Price 1 07/01/2002 MONTERO, JORGE R & BESSY J 15324/146 $278,000 2 10/15/1987 LISENO, FRANK D JR &ANNE MARIE 6000/033 $180,925 3 03/15/1987 FRANCO, NICHOLAS D TRS 5601/341 $14 4 01/15/1985 FRANCO, NICHOLAS D TRS 4287/140 1 $150,000 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2009 $185,900 $2,800 $1,000 $141,800 $331,500 2 2008 $193,100 $2,800 $1,000 $147,700 $344,600 4 2007 $228,000 $2,800 $1,000 $166,900 $398,700 5 2006 $204,200 $2,800 $1,000 $169,400 $377,400 6 2005. $187,900 $2,800 $0 $135,100 $325,800 7 2004 $139,800 $2,800 $0 $155,400 $298,000 8 2003 $133,700 $2,800 $0 $54,900 $191,400 9 2002 $133,700 $2,800 $0 $54,900 $191,400 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=18600 8/20/2009 Parcel Detail Page 3 of 3 CI 10. 2001 $133,700 $2,900 $0 $54,900 $191,500 11 2000 $105,800 $2,900 $0 $33,500 $142,200 12 1999 $105,800 $2,900 $0 $33,500 $142,200 13 1998 $105,800 $2,900 $0 $33,500 $142,200 14 1997 $100,100 $0 $0 $26,800 $126,900 15 1996 $100,100 $0 $0 $26,800 $126,900 16 1995 $100,100 $0 $0 $26,800 $126,900 17 1994 $100,700 $0 $0 $42,200 $142,900 18 1993 $100,700 $0 $0 $42,200 $142,900 19 1992 $114,500 $0 $0 $46,900 $161,400 20 1991 $123,400 $0 $0 $46,900 $170,300 21 1990 $123,400 $0 $0 $46,900 $170,300 22 1989 $123,400 $0 $0 $46,900 $170,300 23 1988 $0 $0 $0 $17,600 $17,600 24 1987 $0 $0 $0 $17,600 $17,600 Photos - !SkY t z „a http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=18600 8/20/2009 ��' w � �s � _ � *�� � ❑ Delete NFIRS - 1 -01922 7/23/20091 1 001 I. A290649 0 ❑ Change State Incident Dale y Station InadentNumber. Exposure ❑ No Activity BASIC Location Check this box to indicate that the address for this incident is provided on the wlldland Fire Census Tract 10 l Module in Section B'Alternative Location Specification".Use only for wildland fires: ® Street Address I I 19 SEATERN El Intersection W WAY . ,U Number/Milepost Prefix Street or Highway Street Type Suffix El In fro nt t of ❑ Rear of I Hyannis 62601 ❑ Adjacent to Apt./Suite/Room City State 'Zip Code ❑ Directions ❑ Cross street or directions,as applicable rill C Incident Type E1 Dates&Tim s Midnight is0000 E2 Shifts&Alarms 900 1 Special type of incident, Local Option IncidentType ether Check dates are nt Da our Min Still u dates are the ��! uir II "R D Aid GIVen_ReCelVed same as Alarm y Shift or No Of AlarmVistrict Date.. Alarm; 07 009 19:20 platoon 1 ❑ Mutual aid recei ed II I II II ARRIVAL required,unless canceled or did not arrive 2 ❑ Automatic aid recv. L� �-1 InI ® Arrival 07 v 23 2009 19:29 E3 Special Studies 3 ❑ Mutual aid given Their FDID S e ) ) A Local Option, 4 ❑ Automatic aid given CONTROLLED optional,except for wildland fires 5 ❑ Other al given ❑ Controlled ,U U I I II II�JI N ® None 'LAST UNIT.CLEARED,required except wildland fire Spec al Special Their Incident umber ® Last Unit Study>ID# Study ValueCleared 07 23 , 2009 19:45 , F Actions Taken G1 Resource's G2 Estimated Dollar Losses &.Values Check this box and skip this section if an LOSSES: Required for all fires f known. Optional for non fires. 86 �lnyestigate I ❑ Apparatus or Personnel form is used. Primary Action Taken(1) Apparatus Personnel .Non Property I ) ❑ Suppression0� I 1 .- Contents I_ Additional Action Taken(2) EMS 0 �OU�- PRE-INCIDENT VALUE:. optional Other. .,. I Property Additional Action Taken(3) Check box if resource counts include aid ❑ received resoyfoes. Contents I ❑ Completed Modules H1 Casualties ® None H3 Hazardous Materials Release, Mixed Use Property Deaths Injuries N'® None i ❑Fire-2 Fire NNN Not mixed ❑Structure-3 Service ' .� I I 1 Natural gas:slow leak,no evacuation or HazMat actions 10 ❑ Assembly Use � . L n� ❑ 2 Propane gas:'<21 lb.tank(as in home Bea grill) 20 ❑ Education use ❑Civilian Fire Cas.-4 ❑ 33 ❑ Medical use 3 Gasoline:vehicle fuel tank or portable container ❑Fire Serv. Casualty-Civilian I-� �0� ❑ 40 ❑Residential use ❑EMS-6 4 ❑ Kerosene:fuel burning equipment or portable storage 51 ❑ Row of Stores 5 Diesel fuel/fuel Oil:vehicle fuel tank or portable storag El HazMat-7 Detector. ❑ ❑ Enclosed mall Wildld Fi8 H2 6 ❑ Household solvents'Home/officespill,cleanuponly 58 ❑ Business&residential - ❑ an re- Required for confirmed fires. 7 Motor oil:from engine or portable container 59 ❑ Office use Apparatus-9 ❑ 60 ❑ Industrial use 1 ❑'Detector alerted,occupants 8 Paint:from paint cans totaling<55 gallons Personnel-l0 h. ❑ 63 ❑ Military use 2❑;Detector did not alert t em 0.❑ Other: Special HazMat actions required or spill gal., 65'❑ Farm use U❑I Unknown Please complete the HazMal form 00:❑ Other mixed use J Property Use Structures 341, ❑ Clinic,.Clinic Type infirmary 539 ❑, Household goods,sales,repairs 131 Church,place of worship 342 ❑ 'Doctor/dentist office 579 ❑, Motor vehicle/boat sales/repairs ❑ 361 :❑ : Prison or jail,not juvenile 571 ❑ Gas or service station 161 Restaurant or cafeteria ❑ Bar/tavern or nightclub 419 [1 1-or 2,family dwelling 599 ❑ Business office 162 . 162 ❑ Elementary school or kindergart. 429 El Multi-familydwelling 615 El Electric generating plant ❑ 439 ❑ Roomingiboarding house 629 ❑ Laboratory/science lab 215 ❑ High school or junior high, 449 241 College,adult ed. ❑ Commercial hotel or motel 700 ❑ Manufacturing plant ❑ 459 ❑ Residential,board and care 819 ❑ Livestock/poultry storage(barn) 311 ❑ Care facility for the aged 464, ❑ Dormitory/barracks 882. ❑ Non-residential parking garage 331 ❑ Hospital _ 519: ❑ `.Food and beverage sales 891.:❑ ,Warehouse - Outside ❑ �36 ❑ Vacant'lot' 981 ❑ Construction site 124 Playground or park 9 124 Crops or orchard D Gradedicared for plot of land 984 ElIndustrial plant yard 946 669 ❑ Forest(timberland) ❑ Lake,river,stream F 807 ❑❑ Outdoor storage area 99511 ❑ Railroad right of way 919 Dump or sanitary landfill ❑ Other street Look up and enter a Property Use 931 [3Open land or field 961 ❑ Highway/divided highway Proert Use code youphave NOT checked a * 419 ❑ 962 ❑ Residential street/driveway Property Use box: I 1 or 2 family dwelling NFIRS-1 Revision OW11 a A290649 EXP 0, 712312009 PAGE 1 OF 2 HYANNIS FIRE DEPARTMENT MFIRS REPORT I_ness name(if applicable) U I MONTERO I I I sboxif IBESSY _ Suffix Aressas `MI Last Name ,f location. Mr.,Ms.,Mrs. First Name WAY WAY ;,`skip the three 19 I SEATERN 'ate address Street Type Suffix ems' NumberlMilepost Prefix Street or Highway L IHyannis Post Office Box Apt./Suite/Room City u i 02601 State Zip Code ❑More people Involved? Check this box and attach Supplemental Forms(NFIRS-1S)as necessary. Er Same as person involved? BESSY I508-862-2791 K2Owner ®Then check this box and skip Phone Number �e Local Option the rest of this section. Business name( applicable) I.0 IMONTERO I Suffix ® Check this box if IBESSY MI Last Name same address ns Mr.,Ms.,Mrs. First Name incident location. L� � I WAY WA Then skip the three 19 I SEATERN duplicate address Street Type. Suffix lines. Number/Milepost Prefix Street or Highway I I __J IHyannis Post Office Box Apl./SuilelRoom City MA I 02601 State Zip Code L Remarks: Local Option i j + I I!� I — i ® More remarks?Check this box and attach Supplemental Forms ITEMS WITH A � MUST ALWAYS BE COMPLETED! (NFIRS-1S)as necessary. I M Authorization Captain /EMT . Suppression :07 23 2009 197201 (Craig E Farrenkopf C. I p Month Day Year Position or rank Assignment Officer in charge ID Signature Check box'rf same as u 23 2009 Officer in I Lieutenant Suppression 07 charge. 198201 IThomas F Kenney Month Day Year Position or rank Assignment Member making report ID Signature _ page 2 of 2 19 SEATERN WAY I a290649 - ExP 0, 712312009 - HYANNIS FIRE DEPARTMENT - MFIRS REPORT A I s2 A 7/23/2009 — 001 A290649 0 ❑ Delete NFIRS - 1S ,L Slate Incident Date 9 I tation Incident Number _L Exposure ❑ Change `SUpplelll@I1t8I � 7i IC J Remarks 19 SEATERN WAY .7,tESPONDED TO THE ABOVE ADDRESS AT THE I2E'QUEST OF FIREFIGHTER SYLVESTER. HE JVAS AT THE LOCATION ON A RESCUE CALL FOR AN ASSAULT. UPON MY ARRIVAL I MET WITH FIREFIGHTER SYLVESTER AND HE REPORTED WHAT APPEARS TO BE ISSUES WITH A, BASEMENT APARTMENT, IMPROPER STORAGE, AND SMOKE DETECTORS REMOVED. I ENTERED THE BASEMENT THROUGH THE BULKHEAD AND FOUND THE RESIDENTS REMOVING BOXES OF CLOTHING FROM A SMALL ROOM CONTAINING THE GAS FURNACE AND WATER HEATER. I ALSO OBSERVED A SMOKE DETECTOR LYING ON THE COUCH. THE BASEMENT IS FINISHED WITH A FULL KITCHEN, BATHROOM, 2 BEDROOMS, AND A LIVING ROOM WITH THE PRIMARY ENTRANCE AND EXIT BEING THE BULKHEAD STAIRS. I SPOKE WITH THE NAMED OWNER WHO REPORTS 5 FAMILY MEMBERS RESIDE IN THE BASEMENT. SHE FURTHER STATES THAT SHE OCCUPIES THE FIRST AND SECOND FLOOR WITH HER FAMILY OF 7, FOR A TOTAL OF 12 PERSONS AT THE ADDRESS. I EXPLAINED THAT THE SMOKE DETECTORS SHOULD NOT BE DISABLED AND ALSO FOUND THE FIRST FLOOR DETECTOR"CHIRPING". I PUT THE BASEMENT DETECTOR BACK IN SERVICE AND ADVISED HER TO CALL AN ELECTRICIAN TO HAVE THE SYSTEM SERVICED. SHE WAS UNSURE IF A PERMIT WAS OBTAINED FOR THE BASEMENT RENOVATIONS OR WEATHER THE PLUMBING,BUILDING, OR ELECTRICAL INSPECTORS HAD BEEN THERE. I ADVISED HER THAT I WOULD BE FORWARDING THIS REPORT TO FIRE PREVENTION FOR FOLLOW UP. THOMAS F. KENNEY LIEUTENANT 072309 A290649 - EXP 0, 7/23/2009_ HYANNIS FIRE DEPARTMENT MFIRS REPORT TO ALL NEW BUSINESS OWNERS DATE: Fill in please: . APPLICANT'S01111 YOUR NAME: U `Tt _ BUSINESS YOUR HOME ADDRESS: 1 S(=A — �Q LL pq.1 I Az 0 O TELEPHONE Telephone Number Home NAME OF NEW BUSINESS w ��-�� ��� TYPE OF BUSINESS . IS THIS A HOME OCCUPATION?—�YES N sklouj k=�CU Have you been given approval from the building division? YES2] fC NO -7 ADDRESS OF BUSINESS I MAPIPARCEL NUMBER When starting a new business there are several things you must do in order to be incompliance with the rules an regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St.—(corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed f any mit requirements that pertain to this type of business. Authorized Signature* COMMENTS: -fit D IN1l/ u-� Y7,L6j " 2. BOARD OF HEALTH This individual has b_ewn inf med-9f the permit requirements that pertain to this type of business. thonzed ignature" COMMENTS: /I44 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual ha�een inforpwd of the licensing requirements that pertain to this type of business. Authorized Signature" COMMENTS: - Business certificates (cost,$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. -it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. "SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. TO ALL NEW BUSINESS OWNERS DATE: 1 t—_-8^2fo law Fill in please: mom APPLICANT'Son ISO YOUR NAME: BUSINESS YOUR HOME ADDRESS: f P.l A--- TELEPHONE Telephone Number Home NAME OF NEW BUSINESS � o 't�1� Z TYPE OF BUSINESS IS THIS A HOME OCCUPATION? _YES N Sit pGJ �[ Have you been given approval from �the 'building division? YES NO ADDRESS OF BUSINESS S 2+,4 wit< IS MAPIPARCEL NUMBER :Z� When starting a new business there are several things you must do in order to be in compliance with the rules an regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures,- listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall) or if you get the business certificate first. you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St.—(corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed f any mit requirements that pertain to this type of business.. Authofteo Signature'` COMMENTS: OcC l A(J I u L��p WLerL"' 2. BOARD OF HEALTH This individual has b inf med the permit requirements that pertain to this type of business. thorized ignature** - COMMENTS:�Q/J !�4' ,bzdi:;�- 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual ha en infor d of the licensing requirements that pertain to this type of business. Authorized ignature** COMMENTS: - Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. -it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. **SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. Town of Barnstable of�ror.� Regulatory Services Thomas F.Geiler,Director • snaxsTnaM Building Division -- - - v� MASS Tom Perry,Building Commissioner rED MA'S► 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: a?.s Permit#: HOME OCCUPATION REGISTRATION Date: 0-1 O 5 Name: 21��5-+ �OR-G � 11 C)t 't—O Phone#: o� gC�`�- �2`1 q� Address: Ll `J AT E�� W.4�a Village: e•A ►-4 L Name of Business: 0 Type of Business: t�N1 i Q C LA�P I l J � Map/Lot: a sr �J ' INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Date: 11-o -o, Homeoc.doc Rev.5/30/03 TO ALL NEW BUSINESS OWNERS DATE: 12.- 0 1- o S Fill in please: APPLICANT'S YOUR NAME: 0QCA� 6w tk 01\1-T r=-�� BUSINESS YOUR HOME ADDRESS: I q S . _r9 (2-N wA 9 _ 502- Z3--- 26s-i- �® IA- j Ari iJ LS V'lA TELEPHONE Telephone Number Home octb NAME OF NEW BUSINESS L_owR O���� 02 S'T. TYPE OF BUSINESS_ q;.,a�yDSC� P}N -F1.atu1 IS THIS A HOME OCCUPATION? YES NO 7�cn��% °�` W Have you been given approval fro the building division`? ES�NO ADDRESS OF BUSINESS S E�1 �� S Z MAP/PARC.EL NUMBER �( --1 When starting a new business there are several things you must do in order to be incompliance with the rules and regula ons of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St.-(corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS i 2. BOARD OF HEAHrts onl LT V This individual hp een i rm of t e permi requirements that pertain to this type of business. Authorized ignature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature" COMMENTS: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. -it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. "SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. Town of Barnstable Regulatory Services- ThomasF.Geiler,Director Building Division + BARNSrABLE. y MASS. g Tom Perry,Building Commissioner �AtE1639. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: o��. _ Permit#• HOME OCCUPATION REGISTRATION Date: U l— 2,ct— l O Name: X �¢} P hl 0 n�2� Phone#: �b L3 3-(� � Address: �, S 11 W Village: ►1 Z S Name of Busiraess: ��E%Sj��1- c� _ h2 -o Type of Business: L ck C cs te e Map/Lot: -L S( 2-3'-1 INTENT: It is the intent of this section to allow the residents of the"ho�wn of Barnstable to operate a home occupation mthin single family dwellings,subject to the provisions of Section 4-1.4,of the Zoning ordinance,proNrided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor; no Visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,it customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dhvelliug which are not customary in residential buildings,and.there is no outside evidence of such use. • No traffic will be generated in excess of normal residential Volumes. • Tlae use does not involve the production of offensive noise,vibration,smoke,(lust or other particular matter, odors,electrical disturbance,heat;glare,humidity or other,objectionable effects. • There is no storage or-use of toxic or hazardous materials,or flananaable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,'and not within the required front yard. • Tiiere is no exterior storage or display of materials or equipment.. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Horne Occupation. • No sign sliall be displayed indicating the Customary Home Occupation. • If tine.Customary Home Occupation is listed or advertised-as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have react and agree\%itth"the above restrictions for nay home occupation I ann registering. Applicant: O Q �. CC v O Date: t^� � �� ''i Homeoc.doc Rcv.01/3/08 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for.4.years). A business certificate ONLY REGISTERS YOUR NAME in town (which , you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1" FL.; 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: Fill in please: rig, , APPLICANT'S YOUR NAME/S: _ �, v t on '� `` ' Ark- BUSINESS YOUR HOME ADDRESS. ; o .ti �., Sw _ 355 'k2 TELEPHONE # Home Telephone Number - NAIVIE`OF CORPORATION: NAME OF.NEW.BUSINESS - PE:OF BUSINESS . �6� IS::THIS A-HOME OCCUPATION?- :- YES ':: ND _.. ._ ADORESS:OF BUSINESS . &h . :: -. v : MAP PARCEL NUMBER ill G (Assessing): When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST, GO TO 200'Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING C0MMI%A ' R'S OFFICE This individual h .infla o any ermit re uirements that pertain to this type of business. MUST COMPLY WITH HOME OCCUPATION i Sign._ re** RULES AND REGULATIONS. FAILURE TO COMMENTS i, COM LY AY Rt=CULT 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) A. This individual has been informed of the licensing requirements that pertain to this type of business.' Authorized Signature* COMMENTS: 50(� 00 . .2 00 3 00 moo` 00, t. Burnham, Richard 1 C ,(,� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # i s _Health Division 2 0-S Date Issued Conservation Di on Application F Planning Dept. Permit Fee': Date Definitive.Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village \�i�,•�h. Owner �Oy�P, BQg 1 11t!a Address l Telephone 5O ?6rL.- ` a IM ermit Request (1 e r-,.o L),P- v,-- Vo S'� ��•e G j ko3� . c rt �2e Of Z v5 M e t Cve� S WeT�S(A6tn� G,,v— 4d2� Square feet: 1 st floor: existing proposed 2nd floor: existingpropoTotall eew Zoning District Flood Plain Groundwater Overlay �-n 2.1 fp t Project Valuation ` Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach suppo ing doc menion. 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: 2� _ existing 0 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 p APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �tsyst 0 SS Irat)J,ev"10 Telephone Number S-0 `Address S2v7Ve t,!!� uxb i License# vA 3LS�1AAA c Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE _ DATE — d s FOR OFFICIAL USE ONLY :Y k APPLICATION# y <DATE ISSUED MAP/PARCEL NO. 3 ADDRESS VILLAGE - k OWNER DATE OF INSPECTION: ' FOUNDATION FRAME r INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING " — fO DATE CLOSED OUT ASSOCIATION PLAN NO. t 'r ' The Commonwealth of Massachusetts ,Deparitnent of Industrial Accidents r Office of Investigations* 600 Washington Street BOStDK, MA 02111 wwlv.mass.gby/dia y`y, surance Affidavit: Builders/Contractors/Electricians/Plumbers workers, Compensation In Please Print Lefxxbly Applicant Information ' N3ITl0-(Bu'.— Organ ization/fndividual): Addresses _ w Phont. St City_ /�te/Zip �Z[��� 'Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4• ❑ 1 am a general contractor and I 6 ❑New construction have hired the sub-contractors employees (full and/or part,tim.e).* listed on the attached sheet. T. ❑Remodelin g ,2.❑ I am a sole proprietor or'partver-' These sub-contractors have g, ❑ Demolition ship and have no employees ' ' working,for me in any capacity. employees and Have workers' 9 [:]Building addition comp. insurance.$ [No worker's,.comp.-insurance 10. Electrical.repairs or additions S. ❑ We are a corporation and its ' required-) officers have exercised their 11.❑Plumbing repairs or additions C�3` I�a meowner doing ail workright of exemption per MGL �(C myself. [No—worleers comp. 12. Roof repairs c, 152 1(4), and we have no t. • (�..ansurance required:]�t�---�-- ---- employees. [No workers comp, insurance.required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. �. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that cbeck this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp:policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy andjob site information. Insurance Company.Mme: Policy#or Self-ins. Lic.#: Expiration Date: lob Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this:.statemerit may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert under the pains and penalties of perjury that the information provided above is true and correct. ;;--.—Date: Phone#: Offccial use only. Do not write in this area, to be completed by city or town officiaL .City or Town: Permit/License# Issuing Authority (circle one): 1.Board of health 2.Building Department .3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector I', 6. Other Information and nst �xc� ®ems Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in.the service of another under any contract of hire, express or implied, oral or written." other legal entity, or any two or more �� corporation or o g ty ciatio asso n, rP . An employer is defined as an individual,partnership, of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver,or tiustee of an individual,partnership, association or other legal entity,employing employees. However the house having not more than three apartments and who resides therein, or the occupant of the owner of a dwelling g tenance construction or repair work on such dwelling house dwellin house of another who employs persons to do main P g o'r on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or Iocal 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 th6 insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance ith the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to youx situation and if necessary, supply,sub-contiactor(s)name(s),.address(es)and.phone numbers) along with their certificates) of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no'employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the auirtber listed below. Self insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pcm-Wlicensa number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only subnut one affidavit indicating current policy information(if necessary) and under"Job Site Address" (ha applicant should write"all locations in (city or town);".A copy of the affidavit.that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address, telephone-and fax number: Thy Commonwealth of Massachusetts Depai t=e:nt of Industrial Accidents Office of lavestigaaGns. 600 Washington Street Boston, MA 02111 o Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22,06 www.mass.gov/dia Town of Barinstable �Y r o Regulatory Services Thomas F. Geiler,Director - � IARNb'TABLE, Building Division 019 ATto Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www,tovvn.barnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 - - — - '------HOMEOWNER LICENSE EXEMPTION Please Print DATE: Se e:�vh �A9 JOB LOCATION: �- qvillage number street 17 "HOMEOWNER": /J home phone# work phone# name CURRENT MAILING ADDRESS: ��e" �"� 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 Persons)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"Y'certifies•that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that be/she will comply with said procedures and requirements. Signature of meowner. 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 hdshe understands the responsibilities of a Supervisor. On the last page of this issue is.,a form currently used by several towns. You may caret amend and adopt such a forn-/certification for use in your community. �YHE, Town of Barnstable Regulatory Services k � �PNBTAIILE, Thomas V. Geiler,Director v ntAes. $ I �k 039. Building Division fp µp Tom Perry,Building Commissioner 200 Main Street;Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623 Property Owner Must Complete and Sign This Section If Using A Builder r , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for; (Address of Job) Signature of Owner Date Print Name if Property Owner is applying for permit please complete the . Homeowners License Exemption Form on the reverse side. Town of Barnstable Building.- PostThis CardSIL a o That rt'�s'�isible From;theStreetA roved Plans Must be;Retamed on Job and,th�s CardM,ust be Kept Posted Until Final Ins ect�on Has Been Made f A W'ah ere a CerCificateof Occu anc as:Re uiredsuch Buldm shallNot;:;be`Qccupied until a F�nalhlns;pection has been�made Permit �. Permit No. B-18-1102 Applicant Name: MONTERO,JORGE R& BESSY J Approvals Date Issued: 04/13/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/13/2018 Foundation: Location: 19 SEATERN WAY,HYANNIS Map/Lot 251-251 Zoning District: RC-1 Sheathing: F y Owner on Record: MONTERO,JORGE R&BESSY J ` , Contractor.Name Framing: 1 Address: 19 SEATERN WAY Contracto�Licese 2 HYANNIS, MA 02601 f I Est Project Cost: $1,000.00 Chimney: Description: RE-SIDE Permit Fee: $120.00 0 _ Insulation: FeePaid:' $120.00 Project Review Req: y NR Date 4/13/2018 Final: - Plumbing/Gas Ne 14, Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work autozedby this permit is commenced within six months�after issuance. Rough Gas: All work authorized by this permit shall conform to the approved applicatn and theapproved construction documents-for which this permit has been granted. All construction,alterations and changes of use of any building and structures°shall be in compliance with the local zomng5by laws and codes. Final Gas: 2 This permit shall be displayed in a location clearly visible from access street o"road and shall be maintained open for puliI' 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 theeu ding and Fire Officials a e provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: .:% Rough: 1.Foundation or Footing 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection S.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: "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 C t Town of Barnstable *Permit# J �` lJ Va- ryes months from issue date It uilding Department � �,,r�.,m�, fill; � Brian Florence,CBQ �12 2018Building Commissioner _ ! 200 Main Street,Hyannis,MA 02601 �A�►Y www.town.bamstable.ma.us Office: 508-862-4038 ►11 YSrABLE k I Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY ' '1 Not Valid without Red X-Press Imprint ' Map/parcel Number i Property Address �L� �r 6�1 k n h�,C 'V` a g-6 o c,U ❑Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name' 1 Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance pf , Insurance Company Name 1-1 Workman's Comp.Policy# _ Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) r Re-side 0 Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: )suance 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 provement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:MPFILESTORMEXPRESS2017 -- s ?Tie Comwoamveakh ofMassacJmse& Department of1"irrirrst7ia1 Acddefd ow Office of l'mwsligade m 600 Washington Street Boston,lei 02111 ` MplumasLgovIdia Workers' CampensatianInsurance Affidavit:BuildersiCogtr-a,ctaFrsMec&icians/Plumbers AppHcant 7nfarmafon Please Print Nat=O3nMHESSm asri7Xfi� Address` /V, Se,-vfP-Vr7 1/ Cityf tatef / � _ D 6 c7 Phan-lv--. 6019. Z6 5-;L Are you an employer?thecicthe appropriate bow Type of project{repaired}: 1.❑ I am a employer.irith 4. ❑I am a general contractar and I 6_ ❑New construction employees(fish an&or part-timer* Isave hired the sub-cclatmC-to� 2.❑ I am a sale propaietnr orpaifiuer- Usted attire attached sheet: 7- ❑RexnodeHing ship and have no.enployees. These sub-contractom have U❑Demolition 1 WOrdIIg for me in any capacity- e�wy7es and havewodnrs' 9, ❑Building addition .' . [No wodze comp.insurance cacap.inuranc(# required-] 5. ❑ We are a aosporafim and its 10.❑Electrical repairs or adcSfions 3.04.1 am a htnmeoumu doing all work officers have a to vise ,their 1L❑Plumbingrepairs or additions. myselor right of esemptuon per MGL €�a wkers'comp- . , ' an we v 17—❑Roof repaits . insmance required.]1 c 1521L� d hae as p employees.[No wado=, 13.❑Other �D/1 comp,insu a=required-] *Amp ap Hamt fi=t cbeftbos PE1 mast also faloathe swdmbelawstundng du&wo&me compensafi UPOEicyiniiiMM2901L #1 nmevaraeawbusabautdsisaidda[data gdeepa8 slFwodtaadB�lsseaatsid�ca�actors�ttsabniitanewaffidaeitiadiCatiOomcIL fCcm=cft i fbst cb,1r This box mast a as additi—sheet dwvdng ffiemmne of fie sub-contriacftHM sad state whether or notfbose effrtieshaoe amylMes.iftbesab-cnnuacteesbaceemployees,dLey=tst'pmuidethev workeW comp.polkyMmmbez I am an einpIaper Mat,is prmd&ng workers compensation insairance f or my emplayees: Berew is true policy and jab sae inforraafian Insurance CmparzyNaffie: -Poficy, m Self-ins-Luc. Fxpiration.Date: Job Site.A,ddress: CitylState p: Attach a copy of the workere compensationpolicg-declaration page(showing the policy number and expiation date). Failure,to secure coverage as requiredundes Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$150a OG aadlor one-year impris on as welt as civil penalties is the:fona of a STOP WORK ORDFR.and a lime of up to$250-00 a day against the violator. Be advised fiat a COPY of this sbtnnesd maybe forwarded to the Office of Im mstegations ofthe DIA for insmmac+e coverage ve ifrcaricm I Za hereby cetiffljt a dgr th ' s andperuMa affperjjurp diatflse in,foresa&a provi&d abmre is hue and correct Date- 12, . 1 g Phone a- oS�23446.57- " 02kiat ass ardy. Do itat♦wire in thb area,to be completed by city srtown officiat City or Town: PermiflLicense 9 Emning Authority(circle one): L Board of Health 2.Building Department 3.Cit�j Foss Clerk 4.Electrical Inspector rr.Plumbing Inspector 6.Other Contact Person: Phone#: -- — 6 -formation and Instructions .r Mzccachaceffs Ge'neaal Laws cfiapEr M requires all employees to provide wrO='compensation for their employees. PurM3M3ttD this statrzte,an ea playee is defined as°`._.every person.in the seivice of another under any contrmat of hue, expMSS or implied,Drat or wrhtmn An errplaye:is defined as an individual,parfnershi ,association,corporation or other legal euiitp,or arty two or more of the foregoing engaged is a joint ,and including the Legal refire m atives of a deceased employer,or the receiver or trastee of an individnaI,pat imsbip,association or otherlegal entity,employing employees- However the owner of a dweIling house having not more than three apartments and who insides therein,or the ocaoat ofthe - dw-eIling house of another who a nploys persons to do maiatmance,rf.n¢fr=t m or repair work on such dwelling hams or on.the grounds or butZdmg agp�t ifi=to shaR not because of such emplayment be deemed to be an employer." MGL chapter 152,§25C{6)also states that"every sta.�.-or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buffdmgs in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage requn ed." Additionally,MGL chapter 152,§25C(7)states`Neither the coca mmw-u th nor any ofits political subdivisions shall ester into any contract for the performance ofp-ablic work until acceptable evidence of compliance with fae msIrEnce._ rez ji etds of this chaptnr.have:been preseutedto the co_*��a anfboiity." A-pp]lcants please fill orot the wotiCers'compensation affidavit compleftFL by checking the boxes that apply to your sitnation and,if necessary,supply sub-contactor(s)name(s), addresses)and phonenumber(s)alongwittitheirceitificate(s)of rwo:rdnce. Limited Liability Companies(LLC)or L=ted Liability Partnerships(LLP)with no =:Eployees other than,the members or partner are not mquied to cagy woriceas'compensation insurance. If an LLC or LLP does have employees,a policy is re:#:h uL B e advised that this affidavit maybe sibmitied to the Department of Industrial Accidents for confirmation of inset coverage. Also be sure to sign and date the affidavit. The affidavit should be-rstnned to tie city or town tha±the appficaiion for the permit or license is being regnesbA not the Department of . Ldnstrial Aar.;dents- Should you have any questions regaztimg the law or if you.are requnrd to obtain a workers' compmssat cry policy,please call tine:Departmenf at the b=ber listrd beIow. Self-i mm—ed canmpanies should en.�r their self-h miance license nmnbm on the appmpriate line. City or Town Officials please be sore that the affidavit is complete and primed legmly. 'Ihe Department has provided a space at the bottom of the affidavit for you to fall out in the event the Office of Iuvesiigaiioas has to con actYon regmdmg the applicant- Please;be sure to fill in the pennitlli.cense number which will be used as a mfere aw numbee: In addition,an applicant that must sab=d multiple pennit/license applitatioas in any given year,need only submit one affidavit indicating caarzt policy infbrn3ation.Cif necessary)and under`Job Site Address"the applicant should write"all locatiOns in—(city or town)_"A copy of the-air davit that has becat officially stamped or marked by the city or town maybe provided to the " applicant as pMofthat a valid affidavit is on file for fatim permits or Iiceuses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or peLk not related to any business or commercial ventm'e (Le. a dog license or pennk to bum Leaves et�.)said person is NOT required to complete this affidavit - The Office of Iuvcstigatians would like to thank port in.advance for your cooperion and should you have any questiens, please do not hct-rf ±e$,t.�o,give us a caI The Departme:nfs address,telephone and faxnranber: Th-�CDMMMVMIffiE of Massachnset s �Qs11�E�11F Tt,-I.4 617 -4900 eoft 4`06 or I 477 Two AS,SAFF, Fagg 617727 Revised 4-24-07 I i °FSHE l°� Town of.Barnstable Building Department vRARNMHLF .� Brian Florence,CBO MASM `b i659• .m 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 ©Y- e ro as Owner of the subject property hereby authorize - — to act on my behalf, in all matters relative to work authorized by this building permit application for: r (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 erformed and accepted. - z S a e of F Si e 0 Applicant' 0 Print Njpe Print Nam Date Q:FORMS:OWNERPERMISSIONPOOLS Rev:10/17 I Town of Barnstable �oFTt+e row Building Department e� Brian Florence CBO STAB Building Commissioner 9 MASS. $ 200 Main Street, Hyannis,MA 02601 s6;9. ArFD MP't I. www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION, o Please Print DATE: t L t} JOB LOCATION: �` h h-,j O numb street village "HOMEOWNER": aJ2 E71'V'e V13 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 ie'side,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.proced sand requirements and that he/she will comply with said procedures and requirements. Sign o meo r Approval of Building Official get or lar er will be re aired to 'comply with the Note: Three-family dwellings containing 35,000 cubic f g q P Y 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. SCAT.`-ems sa i t n Cn 10 w �IV v � rl 3\ 6G.49 C n'i �y ' I OF Mgf�gy PAULA. c RYLL TOWN OF.-HARNSTABLE ZONING No. 32448 oQ BY-LAWS DATED FEBRUARY 1986 ZONE:- RC-1 C SETBACKS t FRONT = 30' . SIDE 15 REAR 15' PROPERTY LINES SHOWN HEREON WERE COMPILED FROM PLANS OF RECORD AND DO NOT REPRESENT PROJECT NO. 3-1348.05 AN ACTUAL SURVEY ON THE GROUND. ---—— -----THE STRUCTURE DEPICTED ON THIS PLAN WAS LOCATED PLOT PLAN ON THE GROUND BY SURVEY ON JULY 15 19B7 in AND EXISTS AS SHOWN AS OF THE DATE OF LOCATION. SARNSTABLE MASS . THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND SCALE: 1"=20' JULY 20 1987 SHOULD NOT BE USED FOR ANY OTHER PURPOSE: --- . --- ---_._- _______.__...__._ �� L3 BSC I CAPE COD SURVEY CONSULTANTS 3236 MAIN STREET DA ROFESSIONAL LAND S�{ EYOR BARNSTABLE VILLAGE, MA. 02630 M17) 362-B23 F a;. Bath Bath n ? ��, Bcc�oom Bedrnam o SECOX�LEVEL ISO 48.0 26� ��(4 KAdKn Bath owng Room ' • i° t 12.tY b Ciarago ' RAST LEVEE, - 4 , n LMnRo Bedroom R `2 Li t5.0 14.V cyp - - ' , • P�� S t, � � 1R t P dlP.y r �..,'y'�C. Plr"had Baronw4 tV B"EMEHT LEVM v Bath 78.D Skatxh try N- , Yt i, __ _ .__.--_._._..__�..._._.�.._�.._.__..._��._._..._...._.....�__a.__._. .._._ ...._. .__.__.._........__.._�.....�..�._.._ _ .. ......_._..___.. ._....... �_ - III t. t �n ' `y ti• � �A ¢ F i , Y ' I rl Ll /9 _.. II II I f OF Mq IIII o`' PAUL �a � R.II "Ell RYLL TOWN OF BARNSTABLE ZONING No. 32448 BY-LAWS DATED FEBRUARY 1986 ZONE: RC�4 SETBACKS FRONT 30 SI DE 15 REAR 15' PROPERTY LINES SHOWN HEREON WERE COMPILED i FROM PLANS OF RECORD AND DO NOT REPRESENT PROJECT NO. 3--1348.05 it AN ACTUAL SURVEY ON THE GROUND. --------—------- -- —- - --__.__�_. THE STRUCTURE DEPICTED ON THIS PLAN WAS LOCATED P�-0 PLAN ON THE GROUND BY SURVEY ON JULY 15 1987 ! 1 AND EXISTS AS SHOWN AS OF THE DATE OF LOCATION. BARNSTABLE MASS . n � j THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND SCALE 1 20 JULY 20 1987 SHOULD NOT BE USED FOR ANY OTHER PURPOSE. �___._. _,__�_.. �._'i s� T••�-� L3 �,��t 8SC / CAPE COD SURVEY CONSULTANTS C3236 MAIN STREET DA WSSIONAL LAND SUFlEY0R BARNSTABLE VILLAGE, MA. 02630 (617) 362-8133 9. gill ,t I ',I