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Home My WebLink About0185 STEVENS STREET (2) ---- ---- - -- ---- ''GIrli 7�" v? � --- ---- --� I� _ �. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 0�5� `' X�pp lication #i l Health Division .8 Date Issued f� Conservation Division Application Fee - Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address —5f,0,6d t3 Ul Ilrjcje /29arkeMolC � Village van n I S Owner 4 �o rn �?INN A-Cae Iae L I Address 07 kk)(+ 1 Sk, rA1n nJ S Telephone V�C�� 7-7-5 �J `..Permit Request _F 1/0_4 QjT In R,607- U ��MQ >'L� Dct> reg LiI t-ec dUD '-'4-ruc�Luv- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District 0M Flood Plain Groundwater Overlay Project Valuation /4rGO Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑2D Two Family ❑ Multi-Family (# units) ®� �• ii Age of Existing Structure Historic House: ❑Yes No On Old Kin g;'s Highway:r.b Ye's 2QNo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) - Number of Baths: Full: existing new Half: existing ne\/ Number of Bedrooms: existing _new Total Room Count (not including bath>): 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 j C� o(5,9 C!CJIC�CProposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Y ` f _ f,'..,�,,•Name VR Telephone Number Address License # CS- 0 Cq Q ' SSA MCA, Home Improvement Contractor# I . (�� D2__ Worker's Compensation # lu F IAAC°.6C(Yq;5i ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ZI )CA 'A SIGNATURE DATE I I, FOR OFFICIAL USE ONLY ` f _ APPLICATION# ., DATE ISSUED { MAP/PARCEL NO. ADDRESS VILLAGE OWNER S t DATE OF INSPECTION: F -.--FOUNDATION. FRAME x INSULATION 4 t FIREPLACE 'C ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i FINAL BUILDING DATE CLOSED OUT k ASSOCIATION PLAN NO. f . c fZ. 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 Lezibly Name(Business/Organization/Individual): 0�'C1�c4l�l� Addrm:_x9l r7 City/State/Zi O� nn n i S r1.l 2 Phone#: Lo Are you an employer?Check the appropriate box: Type of project(required): 1.[Yam 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 any capacity, employees and have workers' insurance.# 9• ❑ Building addition comp.[No workers' comp.insurance P• 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 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.ROther comp.insurance required.] Give- c uaL�A *Any applicant that cheats box 41 must also fill outthe 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: E\--e ne!�!O- N A-1ocy-6- ="1 S Q ra y- C e ab l'Y1 Qan Polic #or Self-ins.Lic.M C F L1 1t C 0 U O'�J6_1'� Y Expiration Date: (Z1 � AA cc,, -- U rt c.,' Job Site Address: l U'� C-Vf t o 1,.ER4 1`3 City/State/Zip:_ 14�)Cam.Ll r7 f�A4 a Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).[Z&D 1 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 eerd u er.lh a and penalties of perjury that the information provided above is true and correct. Si nature,i> Date; CD! J-4 Phone#: n 7 -7 1 1 Offteial use only. Do not w to 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 [.Other Contact Person: Phone#: ' Client#:586925 20CEANSIDEIN ACORD. CERTIFICATE OF LIABILITY INSURANCE F01ATEDIYYYY) 1311231/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXPEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Dowling&O'Neil NAME:E FAX Insurance Agency A!C`e Ext:508 775-1620 (A/C No): 5087781218 E-MAADDRESS: ` - 973lyannough Rd., PO BOX 1990 Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE NAIL* INSURER A:Arbeila Insurance Company INSURED INSURER B:Everest National Insurance Comp Oceanside,Inc.217 Thornton Drive INSURERC:Safety Insurance Company ", _ Hyannis,MA 02601 INsuRERD; INSURER E; • ' INSURER F COVERAGES , CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD SUBR POLICY EFF POLICY EXP MR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD MMIDDIYYYY LIMITS A GENERAL LIABILITY 8500061423 1/01/2014 01/01/20`15 EACH OCCURRENCE $1 OOO,OOO X COMMERCIAL GENERAL LIABILITY DAMAG 7 RENTED PREMISS Ea occurrence $100 000 CLAIMS-MADE X OCCUR MED EXP(Any.person $5 000 PERSONAL&ADV INJURY . $1 000 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2,000,000 POLICY jECOT ELOC $ C AUTOMOBILE LIABILITY 2434628 01101/2014 01/01/201 COMBINED SINGLE LIMIT Eeacddent 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALLOWNEO kA DULED BODILY INJURY(Per $, AUTOS AUTOS ( ) X HIRED AUTOSOWNED PROPERTY DAMAGE S Peraccldent $ A X UMBRELLA LIHCCUR 4600061424 01/01/2014 01/011201 EACH OCCURRENCE $2 000 000 EXCESS LIABLAIMS•MADE `, AGGREGATE s2,000,000 DDIEDX RETENTION 10000 F $. B WORKERS COMPENSATION BINDER369533 01/01/2014 011011/2015 X I WOSTATU- OTH AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? 7 Y/N NIA ACCIDENT $E.L.EACH C1 OOO 00O(Mandatory In NH) - E.L.DISEASE EA EMPLOYEE $1,000 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 000,000 � E DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD-101.Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER. ' CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE' THEREOF, NOTICE WILL BE DELIVERED 1N f f ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ...yam ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S124076IM 124075 KKM w�- Massacfi'usetts - Department of Public Safety " Board of Building Regulations and Standards Construction .Supm-iso r License: CS-073097 " . PETER A LAROC�E ' IS CEDRIC ROAD Centerville MA 02632 ; �o.-nlr ssicner. 11/03/2014 ffice..of:Consumer Affairs':&Business..9egogtion ME IMPROVFJyAi*I�T CONTt?%IiCTOR rr Type, • 'Explratt �-:; Supplement t' OCEANSI[ El H e%�Iu PETER LAROCHE 217 Thomfon.Dr m .. Hyannis; MA-02601 . CTude,f's�eretary i License or registration:valid for individul:use only before the eapirition date. If found return to:. OftiSe of Consumer Affairs and Business.Regulation 10 Park Plaza-Suite 5170 .ard Boston,MA 02116 Not valid without signature • � 1 f'� S'�v�vS 5 ��, 4 21 15' _ 4' 10" 5' 1�� 5 66 ility Ego Kitchen 'o co v _ • _ Bath o0 * - C3 g; _ r w Oi 4 -17'5" 5-5-1 S 4 n 121 Of d" 11 6,. to 13 N Livina Room �2 4" O Master Bedroom Zo2' to Bedroom 3 8 a, j u 1 u M T ,, 3 f-3 9 -}-- 10 2 11' 1 o" v 'm , 37' 10" Atrium C-� � J,l�O'�TiQmG/C LAP/�i.VCi /9�cicL /�C/rSt3�/'7bc� /ZPiZ/�t/P� apt 3e 20140095_ESERVE Town of Barnstable ti Regulafory Services r 1AIt1V6TABLE, Thomas N.Gei]er,Director 1KA.9S. ' 1 ru +A�� Building Division Tom perry,Building Commissioner 200 Main Sheet,Hyannis,MA 02601 • • �vw•.town.barnstable.ma.iis ' Office: 508462-4038, 'Fax: 5.08-M-MO Property Owner Must. `Complete atid Sign.This Section Xf`Using A.Builder . ;as Qavnct of the subject property heteby authorized-� to net on my behalf, in,a.Il t#tters tda d e to work aiitho&.ed by this bnilding.pam t: (Address of Job) oLY)n�S **Pool fences and alauns ate the i.esppns b:ility of the a PP hca�it. Pools • are not to be.filed.of utilized before fence is installed and;an.Enal inspections aze pedatmm 1.and accepted. Signature.of:Owner: Sigmatoze.of Applicant tdUAY-T 3 fiah e� Print-Natae Paint Name G�� n TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ll IVIa 0 Parcel �D�CA��)-� o% 1 p pp Health Division Date issued 3 `Z-7 l Y �� Conservation Division ' Application Fee Planning Dept. Permit Fee r Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village WtAaymf pp < n,,,, �y�a� Owner ne t(1G MW X _,CE Address A 1 Oi�� UN, f S Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing �"✓J proposed Total new Zoning District 4 Flood Plain hD Groundwater Overlay -•Project VaIuation$5wor Construction Type Lot Size Grandfathered: [ Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) pwd •` � n� Age of Existing Structure Historic House: ❑Yes i14No On Old King's H;ghway:a,0 Ye�64 No Zn Basement Type: ❑ Full` 0 Crawl ❑Walkout ❑ Other h.8YL2— p; R Basement Finished Area (sq.ft.) ® Basement Unfinished Area (sq.ft) 5 Number of Baths: Full: existing new Half: existing new n- Number of Bedrooms: CL existing _new Total Room Count (not including baths): existing ��new First Floor Room Count Heat Type and Fuel: 4(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: YLd�"LA- Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use � - Proposed Use L �A"l'i-�- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � � 1'� Telephone Number 5D Address OC'V N� 1~JI�C ��,S License# l-�✓©� o ��`� Home Improvement Contractor# bL45b Y UJ6 r Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .SIGNATURE DATE C�ig�`f FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME E INSULATION r r FIREPLACE A r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL '7 }' GAS: ROUGH FINAL g RINAL BUILDING r . j U*T&CLOSED OUT f. AOATION PLAN NO. r The Commonwealth of Massachusetts s Department of Indus vial Accidents Office of Invesfigations 600 WashbTfoirSireet Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization/individual): (3 1 L I I ell d CUM, Address: All N0_1 T7 N7 r City/State/Zip: G Phone#: � Are you an employer?aeckthe appropriate box: Type of r ro'ect. general contractor and I P ] (required): 1.0 I am a employer with 4 0 I am a g . employees(full and/or part-time).* have hired the sub-contractors 6. ❑Newconstruction 2.❑ I am a sole proprietor or partner- listed on the.attached sheet- 7. ❑:Remodeling ship and have no employees These sub-contactors have 8. ❑Demolition working for me in'any capacity. employees and have workers' [No workers'comp.insurance comp.insu once. t 9. ❑Building addition required.] 5..❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumb' repairs,or additions 3.El I am a homeowner doing all work ❑ ,.�TAPa.. myself.[No workers'.comp. right of exemption per MGL 12.❑Roof repairs insurance.required.]Ic.152,§1(4),and we have no employees.[No.workers' 13:❑Other comp,insurance required.] *Any.applicant that checks box R.must also fill out.the section below showing their woikers'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. trn ntraan rS that check this box must attached an additional shed showing the namaof the sub-contractors and stata 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.`.Beloiiis thepolicy and job site information. Insurance Y ComP .an ,Name: Q r( Policy#or'Self-ins..Lic.#: Poo Q'" Expiration Date: �� f GG Q� Job Site Address: ` O� � y' - City/State/Zip: GX Attach a copy of the.workers';compeMatibn`policy dc.h ration.page(showing thepolicy;num er and expiration date). Failure to secure coverage as required under-Section25A of MGL c.152 can lead.to, 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 thepains and penalties ofperjury that the information provided above is true and correct Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town ofjMaL 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#: Massachusetts _ - Department of Public Safety Board of Building Regulations and Standards Construction Su penisor License: CS-018226 ' o '7 STUART A BORr"TEIN 297 NORTH STRFEV' HYANNIS MA 02601 Commissioner Expiration 10/31/2015 i - � ,Ojt a . v NOTICE NOTICE T TO TO' E EMPLOYEES EMPLOYEES, The C ' m`ouwealth of Massachusetts T OF INDUSTRIAL ACCIDENTS DEPARTMEN . _ 600 Washington Street,.Boston, Massachusetts 02111 61.7-72749.00 - http./Iwww.mass.gov/dia ,s required by Massachusetts General Law, Chapter 152,Sections 21, 22&30,this will give you notice that I (we)have provided for.payment to our injured employees under the above-mentioned chapter by insuring with: Zurich Insurance NAME OF INSURANCE COMPANY 2420 Lakemont Ave, Ste 100, Orlando,FL 32914 ADDRESS OF INSURANCE COMPANY 12/0712013 to 12/0712014 =U13 4971P50-0-13 EFFECTIVE DATES ;OLICY NUMBER 3owling and O'Neil Insurance Agy.,Inc. 973 lyannough Read Hyannis,MA.02601 $08-775-1620 VAME OF INSURANCE AGENT ADDRESS. � g0�77 PHONE ONE 3uffleld Management Corp. 297.North Street Hyannis,MA 02601 5-9316 EMPLOYER ADDRESS EMPLOYER'S WORKERS'COMPENSATION OFFICER(IF ANY) DATE :MEDICAL TREATMENT The above named insurer is required in cases of personal.injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the.Worker's Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and - reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER �'ME T Town of Barnstable Regulatory ServicesBARNSMLA r Richard V.Scali,Interim Director 16;q. ♦� �Efl tips Building Division - Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: k8-790-6230 Property Owner Must Complete. and Sign This Section If Using A Builder -,as Owner of the to subject l P pay hereby authorize act on my behalf, in all matters relative to work authorized by this building permit SS o ' (Address of job) Pool fences acid 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. F Signatute of Owner Signature of Applicant Print Name Print Name Date t Town of Barnstable Regulatory Services r Ft rok� Richard V.Scali,Interim Director Building Division '* anxxsrasre. Tom Perry,Building Commissioner - 9� 1639., �� 200 Main Street, Hyannis,MA 02601 QED 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": name home phone# work phone# CURRENT MAILING ADDRESS: cityltown 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. DEFE%aTION 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 shall be reMonsible for all such work performed under the building permitfor 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 Appioval 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. Q:\WPFIIM\FORMS\building permit forms\DGMS.doC . Town of Barnstable Building Department - 200 Main Street BARNSTABLE, * Hyannis, MA 02601 9 MASS. i639- $ (508) 862-4038 �� Argo��s Certificate of Occupancy Application Number: 89394>' CO Number: 200900006 Parcel ID: 308025 CO Issue Date: 07129109 Location: 185 STEVENS ST Zonili9 Classification: OFFICE/MULTI-FAMILY RESIDENTIA Proposed Use: PARKING LOT Village: HYANNIS Gen Contractor: ROBERTS, MICHAEL `Permit Type: CCO2 CERT OF OCCUPANCY COMM 2 Comments: FOR UNIT 2E Building Department Signature Date Signed TOf� OF PARCEu ID :3i>8 025 GEOBASE AD ID 2199� DR 'SS 18 ITIEVENS ST PHONE g . HYA ;CiS ZIP _ r LOT N LC135 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT Hal ` �r PERM TT 89394 DESCRIPTION SCry I y~ ... NEW APARTMENT UNITS PERMIT TYPE BR.E`1ODC TITLE COMMERCIAL ALT/CONY O, CONTRACTORS: ROBERTS, MICHAEL ARCHITECTS: Department of Regulatory Services ' A TOTAL FEES: $1,315.00 BOND CONSTRUCTION COSTS $-00 .t $150i,000_00 437 NONRES-/NONHSKP ADD/CONV )BAMSTABLE, MASS. - sbgq.. Al • fD M� f; r BUILDIN ,IVISIO. 1 DATE ISSUED 12/30/2005 BY _ EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISIOPj RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL, PLUMBING AND MECk- (READY TO LATH). PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE: 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTIO APPROVALS 1. 1 vL ff 1 16C 2 lNSv C_ a1) 01< 2�. �� z 3 .?�� 2 G j/ /o o'ay�`ZC 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 „A 2 <1 as 'q, (� ��a� BOAR7 HEALTH OTHER: / SITE PLAN REVIEW APPROVAL WORK SHALL NOT ROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION.