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0201 SIXTH AVENUE (HYANNIS)
�a l SixTN 4Ve. b AAAJAIZS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application 1 Health Division Date Issued Conservation Division. Applicatiion Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board F_1 Historic - OKH Preservation / Hyannis Project Street Address Village Owner Address Telephone 76 ® 7 Permit Request ���rne IAe -�� r K1elP 131,4 deck- 4dvts .4- ►�e VAOUc d2 l s..c 911 ). L s tea e y AJ d > .�up'�+l w fY� o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed.; Total ne W Zoning District Flood Plain Groundwater Overlay -� Project Valuation 71AQM Construction Type M ' 1 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting dot"umen-tation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No: Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing .❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name /`�' r�� e Telephone Number Address T` ® , 66.�,Y2,:21 1504— License # 0 4 '_:�37 Ui vrsfv 1 e-tce fnfV4L./��f��av( v-f Home Improvement Contractor# L60 Y71� I�YL� a 66 1 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /4 SIGNATURE DATE v �/ r/ FOR OFFICIAL USE ONLY APPLICATION# M l DATE ISSUED C { MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 4 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING A DATE CLOSED OUT ASSOCIATION PLAN NO. r• 3 The Commonwealth of Massachusetts Department of IndustrialAccidents 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 Legibly Name(Business/Organization/Individual): ��2 Address: - a -i> City/State/Zip: ,0 Phone#: 5_07 Are you an employer?Check the appropriate box: Type of project(required): 1.El 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.KI am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. 9. ❑ Building addition required,] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. ' right of exemption per MGL Y �o workers comp. 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no � employees. [No workers' 13.EWOther c o comp.insurance required.] COl�e�H,�, —f- �4i✓�� "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. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site 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$1,50.0.00 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 be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and the ins and enaldes ofpedury that the information provided above is true and correct Signafore: Date: Phone#: 4/.5 Official 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 5.Plumbing Inspector 6.Other Contact Person: Phone#: "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 in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If ari"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 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 bum 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: The Comm6nwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia VE Town of Barnstable o� Regulatory Services � ; anitxsrea MASS Thomas F.Geiler,Director 16.19. '��► ' Building Division Tom Perry,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 � `� 1'"i S 1� I.,rE as Owner of the subject property . hereby authorize to act on my behalf, in all matters relative to work authorized by this building petmia (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be"filled or utilized before fence is installed and all final inspections are performed and accepted. i Signature of Owner Signature of Applicant i Print Name Print Name Date QTORMS:OWNERPERMISSIONPOOLS 6/2012 Town of Barnstable °� Regulatory Services r • neRNRI�RiF : Thomas F.Geiler,Director KAM .�•$ Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village -HOMEOWNER : work hone# name home phone# p 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. DEFINPITON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is;or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner t. 4 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 persons)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 in your community. C:\Users\decollilcWppData\Local\Microsoft\Windows\Temporary Internet Files\Content0udook\QRE6ZUBN\EXPRESS.doc Revised 053012 i Massachusetts -Department cif x ubiic Safe Y j Board of Building Regulations and Standards Conoi'tiction Supertisor License. CS-043375 RONALD A RICE" PO BOX 472 West HyannisportMA 02672r qu, Expiration ' Commissioner 04/11/2015 e a7rc9nuaur�e�rlC�a�c-, u"Zcrc/t.rrJe(G Office of Consumer AffM rs&Bwiii as Regulation License or registration valid for individul use only before the expiration date. If found return to: SOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation egistration' 121163 Type: i xpiratioa .4/11I2U14 Individual• 10 Park Plaza-Suite 5170 Boston,MA 02116 RONALD A.RICE RONALD.RICE ;> - 42 BARRY ROAD i WORCESTER,MA 01609. `:-'` Undersecretary Not valid without signature cornfoONWEAt_TH Or MASSACHUSET T S MASS,DEP I APPROVED TITLE 5 SYSTEM INSPECTOR AJi) Ronald A.Rice PO Box 472 Kn West Hyannisport,MA 02672 L, l i S1884 ! V2411996 613012016 PURSUANT TO THE GENERAL LAWS Vi it 1 Intl MUHh k♦AnlNftr�tlae t..NS $ 371o,0`Y ;- This card acknowledges taut the reapient has Successfully completed a 10-hour Occupational Safety an%d Health`Training Course in Construction Safety and'Health Ronald A I Ice Rkhard Hughes April 25,2013 ASSESSORS REF.: � FLOOD ZONE: Map 245, Parcel 83 Zone 8 & C (see plan) Community Panel No. ZONE:-. #250001 0008 D, RB July 2, 1992 Area (min.) 87,120 SF (RPOD) Fronts a (min) 20' OVERLAY DISTRICT: Width min) 100 " Setbacks: AP — Aquifer Protection District Front 20' Side 10' Rear 10' to �ZT #189 21,9 C., N/F 7 Robert & Deborah'Foulconer a ® N87'21'36"E r^ 100.00, OHW�OHw---� V J 7.7' DHW�� Parcel Area • 1.6' 8,000 SF w/f Shed 1 (n = 1 O Ka N N 0 'a i n FF=12.T (NGV029) �\ V' CD ��� m 1 o O 3 r-- Lot 518............. a Cr 1 Lot 520 CD .......... ................. .. . Block }; Pool e _ Enclosure 1D Q :•: 2nd Bench _ Z o 0) - n ::: •::::::::Deck'.::..::;{- O ::; :: :}: x O O N 10 W : t:W:ui:;:,.:::;:.;:::::::: O 0 3 n spa : .4r oo ::: . :.....i::r.::r::. o ar Bench Apron p 8.8' 100.00' C za - _ 87.64' S87'21'36"W #211 rt o N/F Robert J. & Elizabeth M. Heaps I o 1 ^ 3 Existing Decking& Rails � N To Be Rebuilt In Place N No Change to Footprint R1CHgRp R PLOT PLAN L'HEUREUX a N0. 34312 At 201 Sixth Avenue BARNSTABLE N (West Hyannisport) NOTES: MASS, DATE: 121AUG113 SCALE: 1%:20' 1.) Thee structures shown were located, on the ground 0 5 10 15 20. - 30 40 FEET by conventional survey method's on 08/AUG/13. PREPARED FOR' 2.) The.property line information shown hereon was Sherman & Susan•Eisenthal compiled from-available record information. 16 Maple Ave- r Sharon MA 02067 3.) This plan is- not for recording and is not to be used for construction layout or deed description PREPAREDBY: . CapeSury purposes. 7 Parker Road Osterville MA 02655 DWG #. C479_8g1 cpp1 FIELD BY. WKH/JVBJr (508) 420-3994 / 420-3995fax - oFr ►ay Town of Barnstable �y Permit# rpires 6 inoi s frnnr issue re Regulatory-Services FeeE. BARYSrABLE, + 1659- Thomas F. Geiler, Director 1 Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Nurnber Property Address 1 (� � A L, LQJ ❑ Residential Value of Work Minimum fee of$35,00. for work under$6000.00 Owner's Name & Address S/7.9am� yt + fir, �gr,Hy- Contractor's Name „ Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#.(if applicable) C5 L/ PERNT 3 ❑Workman's Compensation Insurance Check one: AI am a sole proprietor SFP - Zola ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance 'TOWN OF BARNSTABLE Insurance Company Name 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 takento s ❑ Re-roof(hurricane nailed) (not stripping. Going over existing layers of roof) ❑ Re-side t #of doors [ Replacement Windows/doors/sliders. U-Value�),�9 (maximum .35)#of windows_ /*Where required:. Issuance ofthis permit does not exempt compliance with oTt-her�town department.regulations,i.e. Historic,Conservation,etc. - ***Note: Property Owner must sign Property Owner Letter of Permission.' s A copy of the 14omeImprovement Contractors License & Construction Supervisors License is required. IGNATURE' c� <t :\WPFILESVORMSIbuildingpermit formslEXPRESS.doC evised 072110 . r The. Carnnionivealih of iMassachitserts r ;: ----- Deparhneztt o,flrtdtilst"rinl Acoi pearls=.. ; Office ofI?p esifigntions. '600 Washington Street' f� J Boston,JIV.! 02111 s� ti4 UIW.ntass.govldin N4?orkers' Compensation Insurance-Ut`;ldaizt:`Builders/Contrictoi s/Electiici zns/Plumbe'.rs Applicant Information ../ Please Print Le "blti Name (Bumne&&'Qrgauizatiou•'Individual): ��.Address: II . � City/`Mate/Zip: h q N 114a- Are you an employer'Check the appropriate bos: Type of.project(re•quii:ed),- 1..❑•1 am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time). * ha' hired the sub-contractors 6- New constnictiou , 2.,,K I am a sole proprietor or parkler listed on the attached sheet. �. t0'Remodeling slu and have no employees These sub-contractors have p p 5 8` �.Demolition working,:for the in any capacity_ employees and have workers" [No workers' comp,insurance comp.insurance. z . 9.. D.Building atiYlitiou 5. We are a co aration.aud.its 10.0 Electrical repairs or additions required.] 0. � 3.❑.I am a homemimer doing all work officers have exercised their 11.�Plumbing rep, or additions Myself [No isorkers'comp" right of encemptiou per tiIGL I .0 Roof repairs irtsurmce required.]r n c- 152,§1(4),and we have no employees. [No'w orkers' 13.:0 Other jll/I n (� 6 Uo�{ cotnp.:tnsurance required.] -Any appficaait that checks box#1 must also fill out the section below showing their tvwken,canYpeusatiou policy infor�t an Homeowners who submit this afh&vit indicating:they are doing all work and then hire autsidc contractors must submit.a new at�davtt indicating such- /Contractors that check this box insist attached an addidonai:ssbeet showing the ns of the sub-contmcinrs anal stare vrhethger or not those entities have emp8oyees. If the sub-contractors have employees,they must provide thair workers'camp.policg number.. I ant all eutploy�er that is providing work�ers',,conipt-nation irtsaar nrrce for tqn,e rployeees. Betof,r,is the polio rrad jo.b site Insurance Company Name: Policy#or Self'ins. L. c.#:, Expiration Date: , Job Site Address: City/state/zip: Attach a copy of the workers'compensation policy diclaration page(shmiring the policy nuniber and expiration,date). Failure to secure coverage as required under Section 25A of MGL c.. I52 can lead to.the imposition of crinunal penalties*of a - fine up to$1,500.00 and/or one-year imptisonn�ent,as well as civil penalties M" the form of a STOP WORK ORDER=anal a fine of up to$250.0�0 a day against the violator. Be.advised that a copy of this statement may be fxWarded to the Office'of Investigations of the D.IA'€or insurance coverage verification. I do here certify rYrtd d pri' sand per 'es gfperjUty'that rite inforinal an provided above,is trsre aitd correct. St tune. Date'' �. Phone#: o nal use only. Do not write in this area,:.to be"coMpieted by citt'or totnrt LaLp City or To-"ml: PermitlLicense# •Issuing A,uthwity(circle one): 1.Board of Health 2. Building.Depurtment.3. C`ity/Ttmim Clerk 4,Electror'5.Plumbing Inspector 6.Ctther : . Contact Person: Phone#: 6 OF IKE 1p� x • • snxxsrnecE, MASS. Town of Barnstable prFD MAY A Regulatory Services Thomas F. Ceiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A. Builder ...- - --- --- — - - - as Owner of the subject property hereby authorize Ov�cL L t f; to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner D to S�S Print Name _ If Property Owner is applying for permit, please complete the Homeowners License Exemption Forma on the reverse side: QAWPFILESIF0RMSlbuilding permit forms\EXPRESS.doC .Revised 072110 z ot►ET° Town of Barnstable Regulatory Services ia'' WS. Thomas F. Geiler, Director a19,. a,-b Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 598-862-4038 Fax: 508-790-6230 ----------------------________ HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER" name home phone work phone# CURRENT MAILNG ADDRESS: city/town state zip code �r The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. ' DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 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 I amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESSAoc Revised 072110 f Nlassachusetts - Department of Public Safety 9 Board of Buildim, Re-ulations and Standards Construction Superviscr License License: CS 43375 Restricted.to: 00 RONALD-A RICE ' ` PO BOX 472 W HYANNISPORT,MA 02672 f' Expiration: 4/11/2011 Conunissioner Tr#: 13230 COMMON'.NEAU H OF MASSACHUSE 1 ii S MASS.DEP I i APPROVED TITLE 5 SYSTEM INSPECTOR Ronald A.Rice PO Box 472 West Hyannisport,MA 02672 � 00 0�•.,]V -tt yrx "M W ME-wYS�i +00 43 r� SI884 I ;;(24/1995 9/30/2013 i l PURSUANT TO THE GENERAL LAWS ✓�ie VominazulPar!C✓z o�✓ltaaaae�u�aea Office of Consumer Affairs&B. siness Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration ,,121163. Type: Office of Consumer Affairs and Business Regulation h ; Expiration. 4M.1)2012 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 RE- R LD A.RICE;:; 3 RONALD RICE t 42 BARRY ROAD WORCESTER,MA 0?609 r. Undersecretary Not valid hood- ature i I A5PNfru I I .X �2 !Z �MC14 lop a MAI I 0.' NC)7 _ ALt GVOoO 1S I j i 1 L � til �v L m E N•s 1 u NA�i. � 6 i I I Zx4" P-AFTERS 24r O.C. I i 1 Koo F ; /9LL: Z5NED5 P Vg • 6)c4 i,E END Lo U.vc-" I 1 i I I I I nt oT Srr o W I I� N i I I i E e�4 x I y �! i I I , yXy6,9 c 4, I a . ii i I i I X ' i i i j ; I I I j i i I � I I i I I i I •. %B.rP�ywoQA j 1 I i 2.xy'r Tvs7s lip "o.c, ; i I I n. CO MMONTWEALTH OF MASSACHUSETTS OF ACCIDENTS -lames WORKERS` COMPENSATTION INSURANCE AFFIDAVIT j 1'?1� (7, �Jim * � . � (l i cc n scc 1 perm i tree) with a principal plan of business/residcnoc at: (�J;� 0 Lh ont (City/Sntc0p) do hereby ecrti{-,under the pains and penalties of pajury.that-. j J I am an employer providing the following workers`compensation coverage for my employees working on this. job. Insurance Company Policy Numbcr [) 12m 2 sole proprictor and havc no one working for mc. 114' l 2m 2 sole proprictor, gener21 contmaor or homcowncr (circle one) and havc hired the eontraaors listed bclov who h2ve the following workers' compensation insurznec poha,cs: '-P/' O- HCA-( bor- -Boi Id Q) A C ;� Namc of Contraaor Insurancc.Company/Pol a-3�Iumber N2mc of Con1r2aor Insurzncc Company/Policy Numbcr N2mc of Contr2aor Insurance Company/Policy Numbcr D l 2m 2 homcowncr performing all the wort:myself. NOTE Please be :� e:3_t while borreo,-en,-�o employ persons to do maintenance,construction or rep:ir wort:on: dwcll;r.�cf.not more than thrcc un;u in v Lla the horrco--cr also res;ccs or on the rounds appurtenant thereto arc not Fcacr:Ily <ons;dcrcc to be employers t:�c'er the C✓or':crs'Cornpcns:t;en Ae,(GL C. 152,sect. 1(5)). application by a boraeowner for a l;eensc or perrnit r..:v evidence the lcEJ st:rus of an ernploycr unicr the Vorlcrs'Cornpcnsat;on AeL l undcrst_.a'th:(a copy of t:-.a s:atemcr.t wiL be fo:wa:&c to the Dcpartrncnt of lndustr;al.Ac6denu•OGree of Insurance for.eoverare. vcrific::;on:nd that fJurc tc secure eovcrzCc a rccc;rcc under Scctio:25A of MGL 152 e:n]cad to the imposition ofs:irnin-0 penalties ccr,s;st c finc of t:p to S1500.GO�.dlor i pri cnnc :c'cp to c.c yc.: :-n�ciY.l per.alucs in LSc form of:,Stop V)ork Ordcr:nd fmc of S 100.00 a day affair.:: r-,c. S1g'nc(l this d2y of , 19 Lice sec/Fermi Licensor/Permiaor C�-TYIE T� Tfic ` oAN-n Of I3-11I-Instafile �.r:_-, ! i ...._ . .. •;� :;�i,, 1 r,� ir�rtlnrc°nt:rl �� r� ic� : \,\�'E�� .. iiuil�in� lli�•i�iotr 367 Main Street,Hyannis MA 02601 Office: 508 79"227 Ralph Crosses Fax 508 775-3344 130ding Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVENINf CONTRACTOR LAW SYMPT.V..MrWT TO PFRMTT APPT TI`ATTnN MGL c.142A requires that the-reconstruction,alterations,renovation,repair,modernization,conversion, improvement, rcmm2l, demolition, or construction of an addition to any preexisting owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residenoe or building be done by registered contractors,with certain exceptions,along with other requirements- T}•pe of Work: � Est.CosyJ666 Address of Work_'c26' 5 I }r± l� A V OwnerName:`Jj IG(— /L(� Date of Permit Application: I herebv certify that: , Registration is not required for the following rcason(s): Work excluded bv-law' Job under S I,000 Building not owner-00cupied �Owncr pulling own pcm-it Notice is hereby given that: OWNTERS PULLING THEIR OWN PEP../,IT OR DEALING NzTFH UNREGISTERED CONTRACTORS FOR APPLICABLE HONE t'.CE I;i N:'OR}; DO NOT HAVE ACCESS TO TI ARBITRATION PROGR -J,1 OR GUARA_','TY FU\'D UNDER NIGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hcrcb\-4� r -iCrnrit 2s the 2-cnt cf t:rcrr , c)g371/ Date Contractor 2mc Registration No. Date ncr C. 1;0 COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY i OF ONE ASHBORTON PLACE BOSTON,MA 02108 MASSACHUSETTS L I I_E�l c- l ` EXPIRATION DATE o3I3t 1"996 Tt.tl.a::_:TFi. ' EFFECTIVE DATE LIC-NO. 126 RESTRICTIONS _,;! 03l3t/1.9Y4 a`I` „ i, I L'1i„Ir. v 4ii _ a JgME� Picc-AATN Z p0 OM 706 m -- '- S pEN015 MA 02660 ;. n Nln FEE'... . } Y p,10T0(BIAS�lG ,.9 1,_T..r_ NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY y` �+ STAMPED-OR-SIGNATURE OF THE COMMISSIONER :-� HEIGHT; _ -- THLS DOCUMENT MUST BE SIGNATURE OF LICENSEE T • I' '1 ^'`�i\rI' CARRIEDONTHEPERSONOF \L THE HOLDER WHEN EN- � MISSIONER - - - OTH PRINT GAGEDINTHISOCCUPATION. HOME IMPROVEMENT CONTRACTOR { Registration,`109314 Type INDIVIDUAL Expiration 09/11/96 PINE HARBOR BUILDING CO.,INC.I. DAMES D: MCGRATH 1aF0 BOX-708/120 6T WESTERN RD j ADMINZWTOR D�NNIS O26b0 Assessor's Office Gst floor Ma Vr, Lot O Permit# k Cons rvation%Jffice Oth floor Date Issued k Board of Health Ord floor �Im Engineering Dept. (Ord floor) House# � Planning Dept. (1st floor/School Admin.Bldg.): iRAMRrASMi NAM Definitive Plan Approved by Planning Board 19 039. �o Mp (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) TOWN OF BARNSTABLE ' Building Permit Application Project Street Address 201 Sixth Avenue Village W• Hyannisport , MA Fire District (hvner James and Sunny ,Nichols Address 201 Sixth Ave. ; W. Hyannisport Telephone 7 71$7 0 7 5 Permit Request: To replace an existing shed in back yard. Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Appeals Authorization Recorded Current Use House garden/lawn eQuir). Proposed Use Same Construction Type Pre-f ab , Existing Information Dwelling Type: Single Family X Two family Multi-family Age of structure Built in 3 0 ' s Basement type N/A / Historic House Finished Old Kings Highway Unfinished Number of Baths 3 No. of Bedrooms 4 Total Room Count(not including baths) 9 First Floor 6 Heat Type and Fuel Gas Central Air Fireplaces i— Garage: Detached None Other Detached Structures: Pool x Attached Barn None X Sheds 1 Other Builder Information Name Pine Harbor Building Telephone number 771-5007 Address 344 Yarmouth Rd; Hyannis .MA License# �� TJ Home Improvement Contractor# �O C� Worker's Compensation # C 2 4 2 4 0 618 C AA NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. A dl-�ezm, ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Project Cost '�`©�© ° O r Fee `��69 SIGNATURE DATE \,'Q'-�� / '7 i BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T FOR OFFICE USE ONLY 4-7 ADDRESS 201_ Sixth Avenue VILLAGEHyannis (W.Hyport) OWNER James & Sunny Nichols 1 DATE OF INSPECTION: FOUNDATION ` FRAIv[E + " INSULATION s , FIREPLACE ' i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: P DATE CLOSED OUT: ASSOCIATE PLAN NO. } y 4 � Z � ice` •r.. �. ,..�.. }�'G G-Gt 4/7I Assessor's office(1 st Floor): Assessor's map and lot number ,� �i,� '" V R o�TH E T o�o Board of Health(3rd floor): Sewage Permit number 'a3-7 t��� • 1 BAsasrAnLL S Engineering Department(3rd floor): y,� Q House number �6 � !/1 c� ° 'bs°' `®0 Definitive Plan Approved by Planning Board 19 �rar a• APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1<00-2:00 P.M.only r TOWN., OF BARNSTABLE :F BULLDIHG :, INSPECTOR APPLICATION FOR PERMIT TO �� ,��el t�J 1� C 1 _6f TYPE OF CONSTRUCTION �'G .� ,{/ / f /A: 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �' 4 !1f Aj ' 4 Proposed Use 4-4 4- Zoning District _ Fire District Name of Owner kf 1>11f e//04 5 Address Name of Builder,./,.+ gar.. X ,c .� +errs 11 � -r�.7,C,'41 <Address f`! L; / Name of Architect "- ` Address Number of Rooms �Y>7 S Foundation k - Exterior ZX" Roofing Floors A % Interior �/T !S�%4 C. 0 C Heating //- Plumbing F f x �� Approximate Cost Fireplace f.a. t � ®//rr i s `•r�f} L' Area p0 Diagram of,Lot and Building with Dimensions f - Fee I J , OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License TM_ NICHOLS, JAMES A=245-083 ` No 3 2 9 8 4 Permit For ADD 2ND FLOOR Single Family DWellinq Location 201 6 th Avenue Hyannisport Owner James Nichols Type of Construction Frame Plot Lot Permit Granted June 15 , 19 8 Date of Inspection 19 Date Completed 19 Assessor's office(1st Floor): K� :. Assessor's map and lot number ,Q� 6�� �&nc Sys-rrhl g4R«S� a. ' �OF T�E Board of Health(3rd floor): �� ,� INSTALLED IN COM 5 IANCE ��Q�#� Sewage Permit number ��'�'� DE AND Z BABJSTADLL i Engineering Department(3rd floor): / y,.�� E�� L� P�9v rnea House number ! /'/ TQVM �LA�Ids 'bsq'6`®�' Definitive Plan Approved by Planning Board ??99 �pY APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only P P R 0 V SOWN OF BARNSTABLE sta a Conservation Com issio BI ILD'ING INSPECTOR r ,� IgHbICATION FOR PERMI e a 2 TYPE OF CONSTRUCTION V 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the follovyfing information: Location l I Proposed Use Xz Ala4,4 Zoning District t Fire District i7at S Name of Owner j 4r47 C t/aLs Address k /2 i)M nn 39yzaoz Name of Builder,�46,s.,11/1�r �?`f 2�"t•,�l,C��r��Address if0 Unx .��. �Z�IV1.r Name of Architect Address / Number of Rooms tV S Foundation /y Exterior r/� f Roofing Floors �� L 1� Interior . Gff Heating Plumbing ,y L Fireplace / Approximate Cost Area Diagram of Lot and Building with Dimensions Fee i f l orb OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License ` L y NICHOLS, JAMES No 32984 Permit For as ADD' 2ND FLOOR n Single Family rDwellhng {' Location 201 6tht;-Avenue cc Hyannisport _ Owner - James Nichols ` Type of Construction FLramef ci, Plot Lot i f Permit Granted June 15 ,. 1 g 89 Date of Instion 19 x Dater omp -19 d• A ,t _.._........ . cFT ELEVATION - '! - i FLCOR _L_. DESc.21�rw_ R:a: uDCM_.16 GSa4Ni n a+D?s_ 3 3UCV0 ♦L.r�dv -32a" PROM' ELEVATION • fi -� �. - .. �'. t Vc PPR OWN GF ! tIon spa t �t p ! 9 17`7�_ a t•.^ QIR �1nRS. TAmlS wc'NOLs a euls. 1 I 1 I lD 1 S• r. AVE a 1- I.._.i -....1 l..t I_� 1 1 ..- ?I G�--�Ir'--' B'9°---ra=------."I4 �---------�_-- `11•. Hy.'«,f Jn A. w.row r..aRn ;40NT C Lr'F:' ELEv.rloNc l �I�pYlaflWU. . v T x o„ AILaHT ELEVATION jj 1C��❑n . � ❑❑ ❑� � 1, C'ryN11LE VE R, FOR �ECONO ELoo4 I 1 - _KExx ELE ygnoy - .• . WwITE CCOnA SwrNGIES l EKI.Twa SR—D as � • __; I ._. __I...._. pIE t mR$. T'nrn6� N�<r10 LS i , 1 S..T- pxTE:T�nE I 1•i itl4 WCST HyPn::S PJRr M? OMYIMO WY6ER RIGHT � R!'� EIEVAT:�IJ$ pr s 11Wi10.IMFp ,. ..,... 1,11 a ♦ ' p � i pq.oPotXD SECWD_FlDcil ..A .� _ . > •.. �'•' Ex,3TIN4 FIRST PL°°R ,F 11 9�--�- --7 S - _ - .{fit. a 1`.C+'.3 ,7 MI 12 $ K,hHEN /Fawlliy Raal+. x 371 (FLt`t 77-7 -77 4,0 ME I DYER HMN4 �• � 1 I I i ' - � � ( � fiE L lARJ 7run£] rvlc trOLS I i I � ' ZOI 51—, AVE. - - WNMbIp MWem FL°o r. 'rL M,IS ON +maorlm Iwn 1. C7DIN.INC Dw l ! . R4aM .. 11 Gur aav*I ! , C9CM Cflu4[. I - ' • � ~O�II - /O� K�RMCN/ FI{MILY ZMM ! , . ------------- d - BEDiLmM A L I { .. AIR MRS 7-s ,s, 1--s ' scut:Y+"- i�o� •roror¢n n w.ww sr�:,c^ { . wCf* Hyo�es P�tr ..,A. 1 nuwwa wuww FftilaUftcU K�rc i.y �1?•n h:uam [/ d 1 CPI-55 SECTION {£.MM E yiiY - -- .CDAA flit R\D6E VENt . ,. , r...y•• CDx....;PLY WOOD D.,rmNIN0 - } -- 4JPMAL7 RmF 5HIN6E-S 1 " 1 2/ZKb WITH Ye° Pi-y—b NEMDERS 6 �— 2xy {iA FT ERS IL" O,C. f ?,NE Titim _ I_ 5" k-3o FI,3excr_wu Ih+SUL.AB+JN axe �LYI' AJs 'I' R.dS.d-�N GLTH en r.AL) - C - 4aB COL.LA.t TIES IN CA-THCDGAL�] I lx$ C.E1uN6 7a�sn "T}.POJ6HOJ7 kd-TM ND,'R S ' - �" _ 3Ya"R-sl F.6cv9L.css r+.sS.,LnneN - S Z.x4 FRA-mE- IL" O.L. � lL.. tna PLywwD SHL:rr+IN 4. WHIrt' CCU-K 6I+IN6LES. FLaO¢ SUrGR 14" O,C. I 2' CANTILEYCR 3 a' -.�uHE F Ilad s+z8 LhLLy COLwHN f G' R-14 Gi6ww4Ltss t+.sSVLwTION - ' El-STING Lxy FICAi+IS - x48" r�cwri Cvrt�err fDNo tL.6F tY t 6 I MR { m25„ 3Amcg NCr1uLi I erne:Yy' I Fyr u.Aovm m w,.AI.+ e-•� . ' an:7.nc I t"ec Zo, .s,rni AT' ' 4iCSt HyArvli i M�. +naew.enon tM►n C2os3 5[CTTuNJ FC.�+.,� O.wMw Me 5 Ls 5 i flJ�"t r WaLtt, Robert D� 100 ,7606 TOWN . OF BARNSTABLE, MASS: I : t� THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO`' _....... ....... „.._.F. ..... „.....'�...L.1..„„._......„................... i /�, ✓.. rr r {. „„„..„...... —, (PROPERTY OWNER) ss Y+" { R (BUILD) - ...... (ALTER) - ( R) - y/,/� (REPAIR) �r' '. i (TYPE OF BUILDING) (APPROXIMATE f LOCATION °a f. .. ._.......„.. .............„. (STREET AND NUMBER) �r (VILLAGE) M„„_.Ww....M.. NAME OF.BUILDER OR CONTRACTOR „�...._„„..... .. ..... ......_..„. . „. ..„... ...._..„ APPROXIMATE COST — E`,-'' _ _ I HEREBY. AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN i OF BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION. ..... ................. _......_„..w_„„.„.... ..„„„....... ._W.„....„.. „_.„„.„.„...,. (OWNER) (CONTRACTOR) - UILDING INSPECTOR i Assessor's map and lot number .c2.45--7:..:.lr�3..... SEPTIC SYSTEM MUST. BE INSTALLED IN COMPLIANCE SewagePermit number ....... . . /h1 .. ��t Lf/ .:• WITH ARTICLE II STATE SANITARY CODE AND TOWN y FTNEIS"T�� TOWN�. ®� �rlid 9133L/ .. "] LOHM INSPECTOR " APPLICATION FOR PERMIT TO .... .. ,..... TYPEOF CONSTRUCTION .........:..........................:................................................................................................ . .....�................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accor n �tohe foil wing informaXn ��)} GTE G� GC ,�G�� •... Location ........575 ..................... ........ ..... . . ProposedUse ............ .............. ......... .................................................................................................................................... ZoningDistrict ......... �?.t............,......Fire District ............ ... . ......................................................... Nameof Own ... ....... ...............Address ..... ............................................................................. Nameof Builder ...... ....... .. .... ... .....................................Address ................... Nameof Architect ...1/ ..................Address .................................................................................... Number of Rooms ....Foundation " Exierior ...............................................................................:....Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Hiciting ..................................................................................Plumbing .................. .............................................................. Fireplace ..................................................................................Approximate Cost ......... ....................................... ............... Definitive Plan Approved by Planning Board ________________________________19________. Area .. . . ................ Diagram of Lot and Building with Dimensions Fee ..... .. ...� ......•..•.... .SUBJECT. TO APPROVAL OF BOARD OF HEALTH :j r I hereby agree to conform to all, the Rules and Regulations of the Town ar stable r arding the above construction. .. f Nam ...... .... _ ..... Ciprariv Louis J. . . ' l�855 '~ add deck to ' �o --~—_.. Permi/ for ------------ . . ...................... - ' Location �—..518.. ________.. � / __'__. West . --.--' —.----.------..^—. . . ' Owner ---- _J�..Cimr�r�______ ' Type of Construction .........f����`------.. ' . ----^-----------------'--.� / ^. � ,6�, —^-------��. Lot ----------.� ' . � ^ . �' December ] 78 ,Permit Granted -----------'—..l9 Date of |nopachon .....................................l9 - � ' Dote Completed — ---.�—.�q ' . . - ^ . . . . . ' . / . PER8&IT.REFUSE0 ------'`.----.--------, lV. � ^ . . � . '----^ ........................ ------------' . /—,_—.~------~.-----..------.. — .-------.-----------.—.---.— . '.. ^ . . . _.___._,___.___,, , ' . Approved _--------------. lg ..................................... ' � ---------------------..---- � \ Assessor's map and lot number .. .. =.... F ` ........:. C. � ..•� Sewage Permit number TOWN OF BARNSTABLE y0*THE T0� Z 319flBSTAXE, i 0 "b 9 BUILDING INSPECTOR t. APPLICATION FOR PERMIT TO ' TYPE OF CONSTRUCTION ............................................................................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �/ G�ii ��/"� /.///� if�s�f/ /� Location .........`..............�.................�.................,.........................�.........�.............................................................................. ProposedUse ..............,. l!a-..{,- !�. 1 .................................................................................................................................. Zoning District ..............:.....`.........::��:@ ...................... ......Fire District ............?�.......... Name of Owner ,���,� ; 1 I � /.r�r .......,,.....Address ..... ..........4.......................................................... ✓i �� � - Nameof Builder ...... .......�.....................................................Address .................................................................................... Nameof Architect ........... ......................................................Address .................................................................................... Numberof Rooms ...................................................................Foundation .............................................................................. Exlerior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior ..................................................................................... Heating ..................................................................................Plumbing• ................. Fireplace ...........................................:......................................Approximate. Cost .........-..:....................................................... Definitive Plan Approved by Planning Board _______________________________19--------. Area G� Diagram of Lot and Building with Dimensions Fee .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH i_ I hereby agree to conform to all the Rules and Regulations of the Town of, B ra nstable regarding the above construction. l �� Names �...... ........ ........?..!�. ............. Cipmar1, Louis J. A=245~83 18855 ' ^ add deck to No ................. Permit for .................................... single family dwelling ............... ' -----------------. . '/ � ' ' - Location ..6tb.Avanom_.,'_..______.. � . West Hyannisport � --------.------~----------- ' �oo1n J. � [kwne, ------_� C1� 1 .—____-- ' ^ ` frame Typo of Construction ---. -------. � . -----^-----------�--------- . F1 Permit Granted .......J).e Q e mile x...3...........ig 76 ^ Dote Completed ' � - ' "E=M=" REFUSED . ' 19 ^ � - .. ...................... . . . Lew . . —''7-----^—~—'' --'' —~^^'^'----^ � . ---.------.—....--~.----.~---.... ' Approved ---------------- 19 � . ' ---------------~----------' -------`-------------~..--... . � ' } ~