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HomeMy WebLinkAbout0010 TOWNHOUSE TERRACE TaW,I1JO u.5- L 1 t/1C ��. :t� �.S �� ((:De '��`��� 1(yu>i,, ( TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION D Application 4C Map Parcel yICGvL`s- pp � � A on# Health Division Date Issued Conservation Division k Application F V Planning Dept. Permit Fe Date Definitive Plan Approved by Planning Board Historic OKH _Preservation/ Hyannis Project Street Address /CI 7�cv A�l 176uS-c' Village Owner /%sl G�/`i. G��► d �1,�5 Address o`� �c�w.� !a �" �'Cr✓ter r Telephone. Permit Request �� ` >2 Square feet: 1 st floor: existing proposed 2nd oor: ex ting proposed Total new- o Zoning District Flood Plain Groundwater Overlay 1 o Project Valuation 6 SG onstruction UpeS' 01 5 iCD Lot Size Gra dfathered: ❑Yes ❑ No If yes, attach orting docurrctation. Dwelling Type: Single Family. . Tw amity ❑ Multi-Family (# units) G � Age of Existing Structure <3 Historic House: ❑Yes. ❑-Pao On Old King.' Highway: ,Yes"❑'i4o Basement Type: ZrFull ❑ 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: O Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: q Yes ❑No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing . ❑ new .size _ Barn: ❑ existing ❑new size_ Attached garage: ❑ existing O,new size —Shed: ❑ existing 0 new size— Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial 4 Yes ❑ No If yes, site plan review# Current Use. ` 4e' C/ T- Proposed Use ..APPLICANT-INF'ORIVIAT'ION �� ++ 11VJIJJ ` �.. r r- r W . � , ' � t �; �56 /� y � nos Buildin Permit Procedu ❑ Lot contains a minimum of 10,000 sq. ft. of conti Certification that all utilities are shut off is required ❑Gas ❑Water ❑Electric ❑Barnstable Engineering if on Town Sewer(no cei The following departments must sign the Building Permi ❑Health Department (8:00—9:30 AM & 3:30-4 ❑Tax Collector ❑Conservation Department(8:30—9:30 AM&:.' ❑Treasurer ❑Historic Preservation ❑ Historic District Commission, 200 Main Street, apl construction/demolition for any properties located in • Old Kings Highway Historic District(nor • Hyannis Main Street Waterfront Historic • Historic Preservation ❑ Site Plan must also be submitted showing the loc ❑ Copy of deed. ❑ Five sets of house plans measuring 11" x 17" scal must include a foundation, cross section,framing sc smoke detectors (locate with a Red `S'.) ❑ Workers Compensation Insurance Affidavit must homeowner takes out the permit, subcontractors hire /Yt�P a�9D• �a�1c�Z. /off • s a ,�r�� ., AC�a n • � r fI • I• � 4 airy Ij � I • Q 7 � � } %. r ,. 1. � . � �0 .I ; � Est // V _ .. .. •- G J a fir! -.. �!. �. , ►{:. Alp ���h/� .a..� � l� \�/� \.LC J Zr �'J �� t���� � 2� ► SHEET.2''.OF- 2 3MEETS i w. S 7 J •a • • JZ PLAN .O/r LAJVO 1. r `saa•)) /N ---- ..w n•w .)f.)r r Bf�RNa$Ti4 �I : + t3LE Puna n, QOa(Q A' r FOrf •..wruan n.nr.rre aro.wo..awor.n to Oval P/MEBROOK OEYELOP/yE/{/7�CORP.'63 s not constitute ap;tonal o! u.+ote.u+c►uoararwv ca.rreea uw 4 a..! �i.c+,:uY. /a•IAfsr CdAT/Ay TWAT 7%VJ A4AN Ae&,f r '+sa`'/)�.•.�'•l;.K.•+i:,/::•✓c�e;••"I Y -LaOarG/Ar7s/:ON , arOl r�[ xatfe \ RN aEysF Ills RZ I 101 Ubdivtr-A AND ACCN'ATFLY06P/C7S TNC LYOB j A rO R•..aa.av.p.prr L ANO 4Nr � mec-" TO OAYFP: :sear. /e,./�a/ a,• •ri y RoadEngineering Pagel of_2 �I I adRAGihSCApLE. - � 1`yQ+y ,4ifG, �e,o',rJ � ,`�l�D i 9_j t+�r' _ 1 F ! CrT/�l/1 �iI fib•��" I Logged In As: RoadTuesday,October 212014 t Frank Schlegel R®ad System, Application Center Road System Reports Road System Search options Search By Parcel by Map Parcel I Map Block Lot 290 104 1 Search I i <Prev Next> Page 1 of 1 Parcel Location Owner Village 2901040AA 2 TOWNHOUSE COURT--UNIT 2 VINTZILEOS, LAZAROS S HY 2001040AB 4 TOWNHOUSE COURT---UNIT.4 MATEVOSIAN,ARAXY D ETAL HY f2901040AC 6 TOWNHOUSE COURT---UNIT 6 IRELAND, LYNN A HY 2901040AD :8 TOWNHOUSE COURT=.-UNIT 8 MATSCHULLAT, ROBERT W.&ARIANE M HY 2901040AE 10 TOWNHOUSE COURT--UNIT 10 STANLEY, JOSEPH HY 2901040AF 12 TOWNHOUSE COURT--UNIT 12 HORGAN, STEPHEN P&CAROL A HY i2901040AG 14 TOWNHOUSE COURT--UNIT 14 ENGELMAN, ROBERT&SARAH HY 2901040AH 16 TOWNHOUSE COURT---UNIT 16 RIVERS, CATHERINE HY j 2001040AI 18 TOWNHOUSE COURT---UNIT 18 GREEN,PENELOPE T HY' 2901040AJ 20 TOWNHOUSE COURT---UNIT 20 DALEY, JEAN M TR HY 290104OAK 22 TOWNHOUSE COURT=--UNIT22. KYLLONEN, MIRIAM G HY 2901040AL 24 TOWNHOUSE COURT---UNIT 24 CHARLTON, DONALD F HY 2901040AM 26 TOWNHOUSE COURT---UNIT 26 NI,YUANKUN &WE[, HONG HY 2901040AN 28 TOWNHOUSE COURT---UNIT,28 LEACH, GERALD E& KATHLEEN M HY 2901040AO 94 TOWNHOUSE TERRACE---UNIT 94 BOTTINO, DENNIS&AMELIA R HY f 2001040AP 92 TOWNHOUSE TERRACE---UNIT 92 KEEFE, JOHN W TR HY f 290104OAQ 90 TOWNHOUSE TERRACE-=UNIT 90 EVANS, GEORGE P.& COYLE,ARTHUR M HY 2901040AR 88 TOWNHOUSE TERRACE UNIT 88 FRY, MICHELLE TR HY 2901040AS 86 TOWNHOUSE TERRACE---UNIT 86 BAKER, MAIRLENE B HY 2901040AT 84 TOWNHOUSE TERRACE==-UNIT 84 SKLAR, MICHAEL B TR HY ' 2901040AUI 82 TOWNHOUSE TERRACE---UNIT 82 LEWIS, WILLIAM J HY r 2901040AV 80 TOWNHOUSE TERRACE---UNIT 80 KERSTIEN, PAU.L S& JANET C `HY 2901040AW 78 TOWNHOUSE TERRACE---UNIT 78 FERNALD, SUSAN L HY. 2901040AX 76 TOWNHOUSE TERRACE---UNIT 76 OUELLETTE,RUTH A HY 2901040AY 74 TOWNHOUSE TERRACE---UNIT 74 HALPERN, ROBERT B HY 2901040AZ 72 TOWNHOUSE TERRACE---UNIT 72- JOHNSON, KELTON D& BEVERLY L 'HY 2901040BA 70 TOWNHOUSE TERRACE;.--UNIT 70 HARSFIELD, KAREN S HY 2901040BB 68 TOWNHOUSE TERRACE---UNIT 68 LUMENTI, ANTHONY C&KAREN HY http;//issg12/intranet/propdata/roadengineerinIg.aspx 10/21/2014 RoadEngineering Page 2 of 2 290104OBC 66 TOWNHOUSE TERRACE—UNIT 66 LUBOS.KY, NATHAN J &DONNA J HY 2901040BD 64 TOWNHOUSE TERRACE—UNIT 64 KOCHAVI, PHYLLIS&DORON TRS HY 2901040BE 62 TOWNHOUSE TERRACE---UNIT 62 MCARDLE, DONALD L&SUZANNE F TRS HY 290104OBF 60 TOWNHOUSE TERRACE—UNIT 60 SHANK, KERRY LYNNE HY 2001040BG 58 TOWNHOUSE TERRACE---UNIT 58 KILROY, PEGGY TR HY 290104OBH 56 TOWNHOUSE TERRACE---UNIT 56 LANTOS, ROBERT L&SANDRA L HY 2901040BI 54 TOWNHOUSE TERRACE---UNIT 54 THAYER,ANDREA C TR HY 290104OBJ 52 TOWNHOUSE,TERRACE---UNIT 52 LOCONTO, DOROTHY A HY 2901040BK 50 TOWNHOUSE TERRACE=-UNIT 50 HOWARD, CAROLINE MCBURNEY HY 2901040BL 48 TOWNHOUSE TERRACE e UNIT 48 RESENDES, JOSE F&MARIA. HY 2901040BM 46 TOWNHOUSE TERRACE—UNIT 46 MCGOWAN, LAUREN L HY 290104OBN 44 TOWNHOUSE TERRACE--UNIT 44 BIRK-MAC CONDO, LLC HY 2901040BO 42 TOWNHOUSE TERRACE=-UNIT 42 COHEN, PHYLLIS HY 2901040BP 40 TOWNHOUSE TERRACE--UNIT 40 MCGRATH, CHRISTOPHER J &DEBORAH B TRS HY 2901040BQ 38 TOWNHOUSE TERRACE---UNIT 38 HOPKINS, JAMES A HY 2901040BR 36 TOWNHOUSE TERRACE---UNIT 36 MAHAN, KATHLEEN M HY 290104OBS 34 TOWNHOUSE TERRACE---UNIT 34 BALEGNO, MARY E HY 290104013T 32.TOWNHOUSE TERRACE===UNIT 32 DESHARNAIS, ROBERT L&VIVIAN V HY 2901040BU 30 TOWNHOUSE TERRACE---UNIT W STETSON, LOIS W HY 290104OBV 28 TOWNHOUSE TERRACE==UNIT 28 BUTTERFIELD, KENNETH L'&MARILYN V TRS HY 290104OBW 26 TOWNHOUSE TERRACE--UNIT 26 ESTRADA, ILIA M &GRAY, DORIS KING HY 290104013X 22 TOWNHOUSE TERRACE^UNIT 22 BEZANSON, CHARLES G JE HY 2901040BY 20 TOWNHOUSE TERRACE-UNIT 20 ALLEN, MARTIN& DELORES HY 2901040BZ 18 TOWNHOUSE TERRACE--UNIT 18 SPARROW, MICHELE L&WILLIAM W HY is 2901040CA 16 TOWNHOUSE TERRACE- UNIT 16 ZIBART, KITTLER B HY 2901046CB 14 TOWNHOUSE TERRACE---UNIT 14 BAGLEY, JOSEPH L&LINDA S HY 290104OCC 12 TOWNHOUSE TERRACE---UNIT 12 SPINA, MICHAEL J HY 29010140CD 10 TOWNHOUSE TERRACE---UNIT 10 SALDI, DIANE N HY 2901040CE 8 TOWNHOUSE TERRACE--UNIT$ 0RPIN, MARILYN L HY I http://issgl2/intrageVpropaata/roadengineering.aspx i 0/4/2014 RO eg ti N tiJim t IN rw r si._ se P ti /• /I 04. ce o ��•� '►• RgCF / 1 1 dr �.. B y j W /o • ,e1 I: tis �� ♦r ♦ lrp,/♦AILI . . /sue•. C DY.`,•� D Jf' + .,o �� - ••L.a do it si a, ,••: 2 i - P,LAOV OF LAND _5.O•./„� :,..�. - BARNS7Af316' a�•asr.•ti:Ir..-v Na.o>ro wir.rcra, ,.Pi2Rl'0� O�af4�r�:foval - .:FOR. 9 P/MEBRODK,DElYELOPME/vT CORK p; u�+o[A li+c wacrv�sltar cwvr�p�yw Ca s not constitu;eapF�ruval 01 3; MOT MI :H ��"q �Or.&-tidrvS� .ORAN•.v DY t 0 c i cr r a.+� L NLRLOY GCRT/iYTAA77AVS aL.+7N`.FULYY q 9re ySaS:.hown A'w "NO ACCVRAT@L'Y OLP/ A.q'.M.' SCi1 L6.:./J,./ �O CTS THE'AA r0/J7 LOCH T/ON A ./�� I�L•�4•• �. rurpos w , NO//N/T N(iMB6MJ O.f TNL - CNa*CA•TO'DY ` REFER TO CW.LP. 183A R.s.,/. aAra : Scs+r /o,(97/ d g r a -c>, ro..ncr or7•t; 9 %r�/7/ CN...vL,rr N. sr vesrY 'iNe. � . 7 !YL JT6�•i0 t No J N✓i/O RFO/.l TtTIO' �j ••`.•• ' N!'ANN/J' 'SO�N Y TMR(/lT` ••21G...L•L�'�.C:'i I //3 70249 d THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) j M DATA 13 Town of Barnstable *Permit# ' �m®I" PERMIT Expires 6monthsfrsr-issue date Dtu 6 - 2005 Regulatory Services Fee Thomas F.Geiler,Director TOWN OF BARNSTABLE Building Division 1 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.townbamstable.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 r--Iz�l / Property Address 1 � —Tf)��� �V'S� N t WI-.( AA A. o Z60 1 [Residential Value of Work ' /6 d Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address A1J G © a. ---r `� �'D I - �J VIt�t.4` tT Telephone Number b Contractor's Name S L Home Improvement Contractor License#(if applicable) tra o Construction Supervisor's License#(if applicable) V. °o a oV d Jorkman's Compensation Insurance o 3 k one: b C N I am a sole proprietor ❑ I am the Homeowner z ❑ I have Worker's Compensation Insurance ti .°' bd c / ' N C C Insurance Company Name a O A Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) L b .0 k: y ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) M ;z z O � ❑ Re-side 3 w o 4 g CK replacement Windows. U-Value a (ma im rm.44) > C 5. � f i ii C O 1IA jy j� •�`�,rs 6 *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Histo� \,tee I1 ai; r C- 10 LU i o L ***Note: Property Owner must sign Property Owner Letter of Permission. o O ome Improvement Contractors License is required. z- vi SIGNATURE'• - `W, � a.�:z �_oc�g =z ms c ¢,,,� a 5, Q:For :exprntrg U.._ o. m, Revise071405 U. U:,,,n Department of Industrial Accidents Office.of Investigations* ' . 600 Washington Street s` Boston,MA 02111 " •` www.mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): V �U-kr�5 1< [ 7C147,�-7 t 3,e }l , _7)AfC Address: 70 7 !M tq* ' <-5r City/State/Zip: .. 1'`1PW1 S* A O Z-60/- Phone#: ; -7 7f -6 O 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 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors ? emodelin 2.❑ I am a sole proprietor or pier- listed on the attached sheet $ g ship and have no employees These sub-contractors have 8. ❑ Demolition working for mein any capacity. _,>vorkers' comp.insurance. g, ❑ Building addition [No workers' comp. insurance 5. LYJ e'are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or.additions 3.❑ I am a homeowner doing all work right of exemption per MGL ME] Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers'' comp.insurance required.] 13.7 Other . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information IN, Homeowners who submit this affidavit indicating they we 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site information. - Insurance-Company Name: �� � ��� �ZDI�P Policy#or Self-ins.Lic.#: I VV 6&0 a Z 70 Expiration Date: Job Site Address: City/State/Zip: / Y��l A M 4 z4vl 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 oriminal 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 aline of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains d enalties of perjury that the information provided above is true and correct: Si mature: Date:• Phone#: Dro 7 —61 (D 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, v express or implied,oral or written." An employer is defined as:_4 indivi4al,partnership%association,Fozporation 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,of the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. How. . , e 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 workvu 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, §25 C(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." states"Neither the con unonwealth nor any of its'political subdivisions shall Additionally,MGL chapter 152, §25C(� 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 cent ificate(s) of insurance. Limited Liabfiity Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members orpartners; 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 maybe 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 member. 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 m. (city or Vwn)."A copy of ihe.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-li6enses..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 ties affidavit The Office of Investigations would lie 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 a' r. 600 Washington Street Boston,MA 02111.. Tel.#617-727-4900 ext 406 or 1477-MASSAFE Fax#617-727-7749 Revised 5-26-05 www,mass.gov/ilia rv� � Town of Barnstable Regulatory Services aixss Thomas F.Geiler,Director ;63� ��� Building Division '°1fD tikA'� Tom Perry, Building commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstabie.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Omer Must Complete and Sign This Section If Using A Builder as O�umer subject property A-,17iji7,4 Q hereby authorize ��;r�c�s y" '� to act on my bahal in all matters relative to work authorized by this building permit application for: o '-I-OwN�vsE Paz 4 wp/L(' Am oZ4 o/ (Addtess of Job) ignatute of Owner Date Print Name Q:FOgM5:0�+�1�E�5I0N �oFtNE� Town of Barnstable *Permit# 69 N °7 P p Expires 6 months from issue date v0 a Regulatory Sevices Fee o��5 BARNSTABLS, g ryr 9� 1 �� Thomas F.Geiler,Director pIED MA'S p` Building Division Tom Perry, Building Commissioner X-PRES.S PERMIT 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 - JUL 2 3 2002 Fax: 508-790-6230 r EXPRESS PERMIT APPLICATION - RESIDENTTAL �F BARNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number o2 7 n n Property Address t7 �p w/,,/t�0 y S fie R R Residential �j Valu Work Owner's Name&Address /AR ro t/I U U/ /O f0 Contractor's Name Telephone Number ;,O� `� 7_'2 Home Improvement Contractor License#.(if applicable) Construction Supervisor's License#(if applicable) e, ❑Workman's Compensation Insurance iv Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# 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 (� Replacement Windows. U-Value • 3 (maxi_rnum.44) ❑ Other(specify) *Where required:Ahsuamnc this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:expmtrg Revised121901 Town of Barnstable �oF tr+e ram, �P o Regulatory Services Vl '� • Thomas F.Geiler,Director '* BARNSTABLE, ' 7 MASS. c� 039. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: O 0 3,)- JOB LOCATION: �O /04�/✓Hd t/ (Z ~~� S number street 9 village "HOMEOWNER':�RRCO � l y �rr SOq y/Z name home phone# work phone# CURRENT MAILING ADDRESS: r ,0 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 perfomled 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"ho owner"certifies that he/she understands the Town of Barnstable Building Department ins ec ' procedures and requirements and that he/she will comply with said procedures and tature ... 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. Q:forms:homeexempt tj Town of Barnstable *Permit OF tHE Tp� E.epires 6 n+onttis from issrle date Regulatory Services Fee A y ass• g Thomas F.Geiler,Director �ATfDMPt"�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 - °' r"r� Office: 508-862-4038 Fax: 508-790-6230 � , r• �= EXPRESS PERMIT APPLICATION — RGSIDI;NTIAL_ ONLI',o,�� , r Not Valid►vithotet Red.'--Press Imprint Map/parcel Number Property Address ( q Value of Work Ba-e-s-idential Owner's Name&Address i ctv�. uQ.�1 ► Contractor's Name u� �� Telephone Number Home Improvement Contractor License#(if applicable) (b 0—?L4 Construction Supervisor's License#(if applicable) CS o S"1�32 j ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I a .-the Homeowner [_I Eve Worker's Compensation Insurance Insurance Company Name �,✓C.�/olo�f Workman's Comp.Policy# �� 3 Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side 1 Replacement Windows. U-Value ✓� (maximum.44) l ❑ Other(specify) exempt compliance with other town department regulations,i.e.Historic,Conservations etc. *Where required: Issuance of this permit does not Signature Q:Forms:expmtrg -� 03/19/03 WEI) oy:39 FA1C 60 S6Y7f1rrp HARVEY INI)USTRIFS � " � 11XANNlS WHSE I�jU111 ENErI 8'If{R F•ARTNE;Ii MW Aff,M Iso9Do1 TEST RESULTS Harvey Manufactured Windows and Doors U-Values in accordance witi'l NFRC-100 • Flased on residential sizes • U- and R-Values are subject to change without notice • Whole wisdom, values • Air infiltraation tasults are subject to change without notice All vinyl windows with Law-ElAigon qualify for the FNFAOY Smrt' progranl throl.lghOut Uie U.S.' Revised 1131103 Clear Insulated 1,111v-lE Lvw-FIA,tgvn` ,fir U-Value R-V111�Ie U-V�Ine Zt-V�lue U-Venue It-Y�h�� (nlill1-:01; l YIN1U_WINpQVNS rrllrlr Classio Double flung (Mechanical) 0.50 2.00 0.37 2.70 0.34 2.94 .0 Classic Double Hung (Welded sash) 0.60 2.00 0.30 2.78 0.33 3.03 .04 Classic Double Hung(Welded Sash & rarne) 0.49 2.04 0.36 2.78 0.33 3.03 .10 Classic Atmustical Double Hung STC40 0.23 4.35 0.18 5.56 U.17 5.88 .09 Signature Double Huny (Mechanical) 0.50 2.00 0.37 2.70 0.34. . 2.94 .04' ignature Double Flung (Welded Sash)- U.50 2.00 0.37 2.70 0.34.• 2.94 11 )Slimline Ueuble Hung (Welded Sash) 0.51 1.95 U.36 2.63 0.34 2.94 .08 Slimline Double Hung(Welded Sash R rame) U.5U 2_UU 0.38 2.63 0.35 2.86 Oy Slimline Single Hung (Welded 5a;h R rarne) 0.50 2.00 0.38 2.6.E 0.35 2.86 .08 Vinyl CasemenUAwning 0.47 2.13 0.34 2.94 0.31 3.23 .01 Vinyl f;asemenVAwning and I1lerrnall Pienel 0.:31 3.23 0.25 4.MO U.24 4.17 U1 Vinyl Designer Shapes 0.49 2.04 0.34 2.94 0.30 3.33 - Vinylllopper 0.47 2.13 0.35 2.86 0.32 3.13 .08 Vltlyl PIctura Wintfow 0.4t3 2.17 0.31 3.23 0.Z8 3.57 .01 Vinyl Welded Deartlite 0.50 2.00 0.34 2.94 0.31 3.23 -- 1 Vinyl'F7raller- 2 Lite rind 3 1-fte-I 0.50 2.00 0.36 2-78 0. 33 3.03 plem msulll.Tre baslld on comiimmiI ,12fiS '1'eWp.Clear 'f}emp Low-6 Temp,Ar>~an Air IJ-VpIoc R-Ynlue If-value R-VAlut U-Vnluc R-VRN't Inlillrultnn rl'mrl�' PA119J29913 Harvey Solid Vinyl Patio Door 0.49 2.04 0.40 2-90 0-37 2.70 U9 Air illfiltratlon is in accoidmice with ASTM E283(tW25 mph. The use of tempered Low-E glass may effect ENeRcr 51nR•qualification in your region. U- and 11-Values Are subject tv chaatr151e wiftluut Notice. The Commonwealth of Massachusetts - — Department of Industrial Accidents -- Office 0//8reSM9290as 600 Washington Street —�� Boston, Mass. 02111 Workers' Compensation Insurance Affidavit flitv location: I O�w'"r 1�� t om ' t • S phone# 781— t ?—J (! (p I am a h owner performing all work myself. I am a sole proprietor and have no one working in any capacity am an employer providing workers' compensation for my employees working on this job company:name:> l _iA01?i2/) Pit Ve 0121-L+ addrem: ci 6c)+V 14- OZ(g 3 s phone# insurance co b Vac -4 n S t/ro(t�deW • POLcy#- C.T! yV .y��d 7 I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who hu.: the following workers'compensation polices: company name• - address::. ci Now- ... companymame•. c tahone# r . may: insnrantx to. polity# Failure to secure coverage as required under Section 25A of f►1GL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/w one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. !do hereby g0rdly under the pains and penalties of perjury that the information provided above is true an coT Cf. l Signature vvr Date t 3` y Print name 7I D hD Id S . Jr. Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# nBuilding Department l pLicensing Board check if immediate response is required []Selectmen's Office r' pliealth Department s contact person: phone tl; r I—(Other . Ve�ised 3195 PtAt . _ ;�/�.� 'i�o�noirosriue�v o�:��.adnac✓wdeQ3 . "',i'► ilom(I of building Itegulalions and Standards HOME IMPROVEMENT CONTRACTOR Registration: 100740 Expiration: 6/23/2004 Type: Private Corporation CAPIZZI HOME IMPROVEMENT, 1160mas Capizzi,jr. 1645 Newton Rd. Coluit,MA 02635 Administrator .�1 'r.�•, ✓�ie Vanr��w�uue� o�../��cuwa:c�ueeda I� , -- BOARD OF BUILDING REGULATIONS License. CONSTRUCTION SUPERVISOR Number'GS 057032 Expire §:09%2612-005 Tr.no: 7171.0 I Restricted: 00 THOMAS X CAPIZZI JR. 1645 NEWTOWN RD" COTUIT, MA 02635 Administrator i j From:Maurabeth Chilson C At The MoCarthY Companies FaxID:9789880038 To:Capizzi HOme Improvement Date:T2/10/ZOU3 T z:It rm rays. IC �i DATE(MMIDOrffM F437 CORD_ CERTIFICATE OF LIABILITY INSURANCE �i�1 12 10 03 ER - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ross i Leighton Cape hoa. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE roes A L Ina.Ageaoy,Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Station Ave So.Yarmouth NA 02664 NAIC# phone:500-394-0946 rax:509-760-1407 INSURERS AFFORDING COVERAGE INSURED INSURER A: National Gran a Mutual IaS. Co INSURER B: SafetV Insurance Camopany xOVement ZDC. INSURERC: Guard Insurance Group C8 i 8$i HOMO � INSURER D: 1s45 Newtown Rd Cotuit NA 02635 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCL)MENT WITH RESPECT TO VYHICH THIS CERTIFICATE MAY BE ISSUED OR _ MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HE IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED By PAID CLAIMS. LIMITS LTR TYPE OF INSURANCE POLICY NUMBER DATE(MWDD DA D EACH OCCURRENCE $1000000 GENERAL LABILITY _ 1 500000 04/Ol/03 04/01/04 PREMISE S(Eeoccurence A % COMMERCIAL GENERAL LIABILITY MPS02733 NEDEXP(Any one person) $10000 CLAIMS MADE I OCCUR PERSONAL 6 ADV INJURY 1 1000000 GENERAL AGGREGATE $2000000 PRODUCTS-COMP/OPAGG $2000000 GENL AGGREGATE LIMIT APPLIES PER: POLICY JERCCT LOC COMBINED SINGLE LIMIT 1 AUTOMOBILE LIABILITY (Ee aoeldert) IS ANY AUTO 1601064 04/01/03 04/Ol/04 BODILY.INJURY $1000000 ALL OWNED AUTOS (Par person) X SCHEDLAED AUTOS BODILY INJURY _1000000 X HIRED AUTOS _ (Per accident) g NoWOWNED AUTOS $500000 PROPERTY DAMAGE (Per accident) AUTO MY-EA ACCIDENT 1 GARAGE LIABILITY OTHER TKW" ACC $ ANY AUTO AUTO ONLY' AGG 1 EACH OCCURRENCE 1 EXCESSNMBRELLALIABILITY AGGREGATE 1 OCCUR CLAIMS MADE j 1 DEDUCTIBLE RETENTION i - X TORY LIMITS ER WORKERS COMPENSATION AND EACH ACCIDENT $100000 C EMPLOYIERT LIABILITY CANC401043 01/01/04 01/01/05 E.L. ANY PROPRIETORIPARTNERIEXECVTIVE - E.L.DISEASE-EA EMPLOYEE 1 100000 OFFICE AAEMBEREXCLUDED? E.L.DISEASE-POLICY LIMIT 1 500000 II yes,describe under SPECIAL PROVISIONS below OTHER - r. DESCRIPTION OF OPERA NS T LOCATIOH81 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVIS NO CERTIFICATE HOLDER CANCELLATION ------1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION r. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAR lO DAYS VVRTTLEN ' NOTICE TO T►IE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABLLITY OF ANY KIND UPON THE INSURER'ITS AGENTS OR REPRESENTATIVES. A THORIgO RE ATTVE l CORD C RPORATION 1ISO ACORD 25(2001108) CAPIZZI HOME IMPROVEMENT INC . Z�O� SPECIFICATIONS AND ESTIMATES PAGE 6 OF 6 STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT OWN THE PROPERTY LOCATED AT IN qct ��j —MASSACHUSETTS. I HAVE AUTHORIZED CAPTZZT HOME IMPROVEMENT INC. TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSTTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT,,IN'ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , COTUIT, MA 02635 APPLICANT'S TELEPHONE: 508f428-9518 RESPONSIBLE OFFICER: i RESPONSIBLE OFFICER ADDRESS: l RESPONSIBLE OFFICER TELEPHONE: i ACCEPTED BY DATE THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL # /