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Home My WebLink About0015 SKATING RINK ROAD -- - �, J -- - --� jjl��7 Mckechnie, Robert From: Mckechnie, Robert Sent: Tuesday, November 20, 2018 12:48 PM To: 'ernanicunhadj@hotmail.com' Subject: APPLICATION #TB-18-3259, 15 Skating Rink Road, Hyannis Good Afternoon, Your application is denied due to the following: 1.) Per The Massachusetts State Building Code 780 CMR R305.1,as amended,the minimum finished ceiling height allowed in a basement is 6'-8 You have shown it to be 6'W. 2.) Per the Massachusetts State Building Code 780 CMR R 303, as amended,ventilation is required in finished basements. You have not demonstrated that the windows you plan on installing will meet this requirement. If you can submit more information the shows compliance with the Building Code listed above,your application will be reopened and reviewed again. Thank you, Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 s 1 5oe �s �y � X0 Soul��q n� 6eVQ 0 - I �LWIs � 'ash r From:' 10/5/2018 To: 10/5/2018 W . . • k 1464 10/5l2018 _ $30 00. _ $30.00 k 46;mow: 10/5/2018 _._ $30.00 I r. - a, u _ _ems � w .. ,$•3.-0--.0-02' nit 1578' 10/5/2018 '�^ $30.00 ��..s..p.#,4 i m-�,':-�,v.'�-m�+"r5a'fi 1 '•K' q `€Y��-, '�:"� t �` �� r,.�cr`��' �} ��'�Ip v„ R $30 001 3476` 10/5/2018 $40.00 n r Y ; k07F1�159_ .10/5/2018' $64 00' , tea F�pFy�az � r $ ��ji ; � e x : _ t jT.� Mckechnie, Robert From: Rildo <Rildo@crabtreecpa.com> Sent: Monday,November 12, 2018 9:49 AM To: Mckechnie, Robert Subject: FW:Application #TB-18 3259, 15 Skating Rink Road, Hyannis Good morning Mr. McKechnie, I am responding to this e-mail on behalf of a friend of mine. The following in red are the answers:, 1.) The finished ceiling height-in.the basement 6 feet 3/inches7 2.) I'nformation-on how you will comply with the code required ventilation. The-window-on-the-proposed-room near thewater heater-will-be replaced'by a window M the same measurements'] of the one in th`e•biiliard=room , Sincerely, `Wo 3.De Sawa J auyca�17epernGttent 426 Arodh Stxeet Ktycuuti6,to 02601 J fwtw#: (508) 79U-2727 3avx#:(5US) 778-2736 Privileged/Confidential Information may be contained in this message and any related attachments.If you are not the addressee indicated in this message(or responsible for delivery of the message to such person),you may not copy,review,distribute or forward the contents of this message to anyone.In such case,you should delete this message from your computer and kindly notify the sender by reply e-mail..Please advise immediately if you or your employer do not consent to Internet e-mail for messages of this kind.Thank you. IRS Circular 230 Disclosure:To ensure compliance with requirements imposed by the IRS,we inform you that any U.S.to advice contained in this communication (including any attachments)is not intended or written to be used,and cannot be used,for the purpose of(i)avoiding penalties under the Internal Revenue Code or (ii)promoting,marketing or recommending to another party who is not the original addressee of this communication any transaction or matter addressed herein. From: ernani cunha [mailto:ernanicunhadj@hotmail.com] Sent: Sunday, October 28, 2018 9:09 AM To: Rildo Subject: Fwd: Application #TB-18-3259, 15 Skating Rink Road, Hyannis Sent from my Whone Begin forwarded message: From: °Mckechnie, Robert" <Robert.McKechnie@town.barnstable.ma.us> Date:October 11, 2018 at 11:16:33 AM EDT To: "'ernanicunhadj@hotmail.com"'<ernanicunhadi@hotmail.com> Subject:Application#TB-18-3259,15 Skating Rink Road, Hyannis Good Morning, The following information is required in order to continue the review of your application: 3.) The finished ceiling height in the basement 4.) Information on how you will comply with the code required ventilation. You can submit this by email. Thank you, Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 2 er.......... ....IRIza5.....a�iieaaonxu� t ; PermitFee.........'.. ........................Otbea Fee........................ s639� 2 Total Fee Paid........... ..4�. . .. w�J _ � ...... .......... ...... n,_ �J . ... TOWN OF BARNSTABLE Pew��..................................on........................ BUILDING PERMIT �2 !.... .....p .... . ..._ _...................... X APPLICATION Section 1— Owner's Information and Project Location Project Address V14-fl PJ 6 rJ Village Owners Name 1 �+)4 CU tA-A- Owners Legal Address-- !�-k A5)4 6 12-1 t�V,- testate- (city Q - Downers cell# &� �1�Sc�r3 �6 — ® 1 . _ : t�-�i'� CON 1 @-t401 Section 2—Use of Stractare Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section-3--Type of Permit, ❑ New Constriction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment w ❑ Addition ❑ Retaining wall ❑ Solar p El Pool El Insulation DrRenovation OCT �� Z�� 6 TOWN OF BARNSTABLE Other-Specify I Section 4 -Work Description-_ ®tom A- `� tti3 -�1 e�cvn1�R lt-sl u►3 or i Act 7mdsdal-2A201 9 Application Number.................................................... Section 5—Detail Cost of Proposed Construction Square Footage of Project Age of Structure Dig Safe Number #Of Bedrooms Existing ;L2- Total#Of Bedrooms(proposed) � fc, 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 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 imdstm-7J92019 A- r CO G) Tj ,n TA SF, YO it oZ , 0 i i i f � F 3T J j The Commonwealth of Massachusetts Department of Industrial Accidents 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): �t�tv I L-rJ Address: �� tJ'C� (�'�J Irk., City/State/Zip: L4�A-opj U, . 02Z 01 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general'contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction. 2.❑ 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 me in an capacity. employees and have workers' -- g y aP �'• 9. ❑Building addition o workers'comp.insurance comp.insuranCe.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumb' repairs or additions 3. I am a homeowner doing all work ❑ � P myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other 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 :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$1,500.00 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 t a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance cov ge ation. I do hereby certi der the pains an enallies of erjury that the information provided abov is true d correct. Signature: �iriL Date: Phone#: Official use only. Do t 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-contractors)name(s),addresses)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 cant'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 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 permittlicense 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 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: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Bostan,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFB Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia 1� �i� ✓ a ca �7 I I d . � r r r J v a — W p; A�i . a P I { UI1�,i�C DIP1 TABLL .� ZA T r P ry . _ 1 2,V A �- ` I i• m. r t.. - 4 / .. - 1 ° t � I � � � I 1 o 11PLOO M �II Q H va r= Q ti 10) rn � z c d a QTO z2 -( f I�Pn��-�oF`� _ for ��/ . .� , � j :, . r ;/ 1.4e,r� fan:_.�._......<:�__.._...___�...�_ �. CC � DA.J r S m 7-T I ' I � o �� i I i, I a 3 i { S n- f t 1 77 f, v. t i U� 77 2. OCT 02 2018 Q TOWN OF BARNSTABLE d 9� r�� f f. f ,.,, .,\'\ �. t' r, � �,�r;I ��r�'�t'i., 1 ��1�' ,f,s ir: t .i,. .,�_ �. �' J n v I� � �. � w �I 1 (` 1 I �' '. L s— 1 I � ,4 � y (t t 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 rales 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 r` Section.10'—Home Improvement Contractor Name Telephone Number Address City State Tip. Registration Number Expiration Date I understand my responsibilities under the rates 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 H.LC... Signature Date Secti6fl-1=HomeTOWners License Txemption, Home-Owners Name: �N Telephone Number 2 ) 3164- D4-13 Cell or ork Number(950 36'� - 1 I understand my responsibilities under the roles and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building I d the construction inspection procedures,specific inspections and documentation by 780 CMR Town f Barnstable. cSignature Date APPLICANT-SIGNATURE 'w cSi e r �� Date � 2t I t� GPrint Name` culikk Telephone-Ni mber_-CG0L_� . c-D-mail-perrn t to: ��1" 1 CGVm :� I a <2 4 , CO(A Section 12—Department Sign-Offs "- Health Department ® Zoning Board Cif required ❑ Historic District ❑ Site Plan Review(if required ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire deparbnent for approval i I Section 13—Owner's Authorization I as Owner of the-subject properly 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 ,i k i r 1 a 'I ' z 1 i f Last wdalzd:2/92018 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application#46-V &.= - Health Division Conservation Divisions Permit# Tax Collector Date Issued Treasurer Application Fee'o Planning Dept. Permit Fee a V Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address S /<-,q 71 /t/-G A/k_ 121b . Village Y A ialIU S Owner"I/ t_ E M e-R_ S,OAJ Address /S /C�1 /�`z�� NA . Telephone �,0 4r — 7 S- S J Permit Request oV/' E 6 iG 7� Square feet: 1 st floor:existing propos d 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation "Construction onstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes,attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure ® Y Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: I 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 '7' new First Floor Room Count Heat Type and Fuel: ❑Gas it ❑ Electric ❑Other Central Air: ❑Yes girl'o Fireplaces: Existing r New Existing wood/coal st ve: ❑g1s O No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑n6w size Attached garage:❑existing ❑new size Shed:�isting ❑new size al/ Other: N ' CD' Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ ry Commercial ❑Yes , ,CB�fQo If yes, site plan review# r.- Cur ent Use Proposed Use J BUILDER INFORMATION Name �- +Z- Dst> Telephone Nu er S Of ' 3 9�-// 3 s A ress / 7%A1Y, 4T/Lel-C f .� License# Home Improvement Contractor# Worker's Compensation# `f ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1 �I'G'NATURE FOR OFFICIAL USE ONLY ' PERMIT NO. DATE ISSUED • I ` MAP/PARCEL NO. . F ADDRESS VILLAGE OWNER DATE OF INSPECTION: .p FOUNDATION FRAME INSULATION ` FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. er� The Commonwealth of Massachusetts _ Department of Industrial Accidents _ Office of Investigations ' _ 600 Washington Street r< Boston,MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance_Affdavit: Builders/Contractors/Electricians/Plumbers Applicant Information (`� Please PrintLedbiy j Name(Business/Organization/Individual): r pl_-S -Address: / -5- S/� 4 rltLJ-e l2� ,v /� f� City/State/Zip: H Y,4 f1JA) 1 02&0/ Phone.#: c�" :�� .S 3 Y5 e you an employer? check the appropriate box: Type of project(required):. L❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction . . employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the-attached sheet. t 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workin for me in an capacity, employees and have workers' S Y P tY• $. 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 101 Electrical repairs or additions 3.%I am a homeowner doing all work i officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance,required.]t c. 152, §1(4),and we have no employees. [No workers' . 13.❑ Other comp. insurance required.] . I I - . *Any applicant that checks box#1 must also fin 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 a loyer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company e: — Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy dec lion page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. an 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 a form of a STOP WORK ORDER and a fine o up to$250.00 a day against the violator. Be advised that a copy of this statement y be forwarded to the Office of vesti ations of the DIA for insurance coverage verification. I o hereby ceeC fy under the pains-and penalties of perjury that the information provided above is true and correct Signatur Date: _ Phone# 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( )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 in`�.nce 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-contfactor(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 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 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 Commonwealth of Massachusetts Department of lndustriai Accidents Office of Investigations 600 Washingto i Street Boston, MA€2111 Tel.4 617-727-4900 ext 406 or 1-877 MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.go-v/dia E?1 Town-of Barnstable Regulatory Services 13 STASM $ Thomas F.Geller,Director 9 MA59. MPS Building biviS1o11 Tom Perry,Building Commissioner 200 Main Street, Hyamais,MA 02601 Office: 509-862-4039 Fax; 508-790-6230 Permit no. Date . AFFIDAVIT HOME MROVEMENT 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: +/V Q.(.C1 P Estimated Cosh F'ddress of Work: /,J /C-/Aj-,x- C, Date of Application: `/0 — '� - I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 QBuildiag not owner-occupied Owner.pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING KITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORHDO NOT HAVE ACCESS TO THE AREITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERTURY I hereby apply for a permit as the agent of the owner: Date Contractor Name RegistrationNo. OR Date er's Name • Q:fomishameafdav ' r SFIE Town of Barnstable DF Tp� Regulatory Services BARNSfABLE. : Thomas F.Geiler,Director 9 MASS. �A 039• ,0 Building Division rF0 MA't A 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: i number street " �+ lla e HOMEOWNER"R 53 /1 3-� J �W � � J a z name home phone# work phone# \ CURRENT MAILING ADDRESS: J5 SK_4 / 61 6., Z I A 1�7 b H y r'Q nj A) ` -s. 61 ,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 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) • s The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. r The dersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department um inspection procedures and requirements and that he/she will comply with said procedures and e�irements.` a 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 t amend and adopt such a form/certification for use in your community. 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( t map Page 1 of 1 t i 1ka .3 . ±f yil1 rt t C"I'il i° t"4f�'t e. h v (`C`Y•`r ^'..y t f I(°�'- rl.� L4 {r, 1r eF3}:�j�'rJ•JJ`1.�1,.it u 'r9,.;;,i.M�.�..�..�3)jirl�-.` � a.G,;?t;£)�)�'i.�,,.�.;,��' :?;).�.,,1't,�,�•aj i..;,,��f(I�`o j ay�'� , ,� �.'CI.' Town of Barnstable Geographic Information System New Search I F Help Pamd Viewer C..Map AbtdEets Map Size z-moul:11111110flIn ]PG Full Map: 291 Parcel: 209 Property Locatiom 15 SKATING RINK ROAD Info '29iftp - p1t21 k.._ ..1ptY1',i_ '� fs9 2enm : sal a� Owner. ODUGHLQI,CA-THEME E a< , iay�:yY,nF' f' 20111w _ Kra,location Information Mlep a.Parod 291209• ' 21t§54 Location, 15.SKA7ING RINK ROAD. t: 0.419 acres 5 i128 2912D8 FE .Current OwnerAM OOt1GHLIN,CATHERIN AddressE8 r fl see EMERSON:PAUL F 071 2S<1�A C 15 SKATHING.RINK RD r� ,N1fANN[S MA 02601 2btM a.ga. 2amst =Appraised Value(FY 2007) Extra PGRU01e9: ;2 500 out suNmllps $600 . Land :153,200 BuiidLgs $95,500 Total Appraised: $251,800 20; 1128 3ette °"' (Assessed Value(FY 2007) ; a3t Extra Features $2,500' a 82 NW, MPep.d4 !n out sulmnes $600 Land $153,200 -- —-— Buildhtgs 595,�. Se!rJCisle 1"_'82 �' ,Atriid PharosYN- ' Tcftl Assesseil: S251:800 ' Copyright 2005 Town of Barnstable,MA All rights reserved.Send q osliws or comments to GIS BamstableMA,vO.2.91[Production] http://www.town.bamstable.ma us/ircims/appgeoapp/map.aspx?propertyIID=291209&mapparbael,�-- 6/29/2007 o •[ page 1 Of l http://w vw.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertylD=291209&mapparback= 6/29/2007 Town of Barnstable *Permit#v��670 780 Expires 6 mont/ts front issue da e Regulatory Services Fee Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner '�- 200 Main Street,Hyannis,MA.02601 1 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 Number Property Address r(/L i ,� Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name &Address AZLK,�_ 17'37), r Contractor's Namert� L� / ( Telephone Number Home Improvement Contractor License#(if applicable)_��(� Construction Supervisor's License#(if applicable) 7 ❑Workman's Compensation Insurance Check one: �I am a sole proprietor - IT I am the Homeowner ❑ I have Worker's Compensation Insurance JUN 19 2007 Insurance Company Name TOWN OF BARNSTABLE. Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side ReplacementtWindows/doors/sliders. U-Value i'7 (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. 00 A copy of the Home Impr vement Con actors License is required. f� Jr�y SIGNATURE: Q:Forms:expmtrg ; Revise061306 I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a d 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): . f '� Address: evio 0 P9e—i City/State/Zip: Phone.#: 59L r m Are you an employer?Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I * have hired the sub-contractors 6• New construction . ,s}nployees(full and/or part-time). Remodeling 2 I am a sole proprietor or partner- listed on the attached sheet. �• ❑ g and have no employees These sub-contractors have g• ❑Demolition p and have workers'working for me in any capacity. employees9. ❑Building addition [No workers'comp.insurance comp.insurance.$ 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.[-_J Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other 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. '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$1,500.00 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 be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and alties of erjury that the information provided above is true and correct: �� v Si afore: ,( Date: a _ Phone#: U F only. Do not write in this area,to be completed by city or town official wn: Permit/License# hority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical.Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f 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 re ever 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-contractors)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 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 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 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: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. ##617-727-4900 ext 406 or 1-977-MASSAFE Revised 11-22-06 Fax##617-727-7749 www.mass.gov/dia J Y.�o ► ��,� Town of Barnstable Regulatory Services 9 $ Thomas F.Geiler,Director �f'�FD►+�'�A,� Budding DiTisioIl Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 ffice:. 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder ,,/fin j, r ' 6o n , as Owner of the subject property hezeb authorize 1 . r 1 to act on m behalf, Y Y in all mattets relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name Q:FORMs:OVINERPERMM SIOI I 14: �/ze �o�re�naiuuea/,C�i o�✓�aooaclivaetia Board of Building Regulations ana Standards HOME IMPROVEMENT(:ONT 2ACTOR f Registration 1,36003 Expiration 5/30/200f3 Fe 4 Type Intlividual BRUCE P.MILLS BRUCE MILLS d ~� 16 CROOKED POND RD; HYANNIS,MA 02601 Deputy.Adminisir:tor :l FRIEDLINE& CARTER ADJUSTMENT, INC. 436 Main Street, P. O. Box 338 Hyannis, Massachusetts 02601 Tel. (.508) 771-3232 FAX r )8) 790-2344 TO: ( 1 wilding Commissioner or Inspector of Buildings O Board of Health or Board of Selectmen ( ) Fire Department TOWN OF BARNSTABLE TOWN HALL HYANNIS, MA RE: Insured: COUGHLAN, Catherine/EMERSON, Pau Property Address:" 15 Skating�Rink Road �Hya is, MA"``' Policy Number: HP970736 Type of Loss: Lightning Date of Loss: 7/16/2006 File#: 105054 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. General Laws, Chapter 143, Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of this writer and include a reference to the captioned insured, location, policy number, date of loss and file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by First Class Mail. G. D. BRIDGE Adjuster 8/25/2006 Town of Barnstable Approved 4// Regulatory Services Fee 9S. l`D Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 9- Cq 3_ no, Home Occupation Registration Date: / Name: I�IJL / oovqkjodl Phone#: �J `.J��`� 9 Address: `� w / n� / � -Village: WUa /21� Name of Business: �� `b�C-� Ve_ll�n �b Type of Business. ��_/ nY r r' n Map/Lot: c 99/_ A 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 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 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: 0 Date: Homeoc.doc