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Home My WebLink About15 LAFRANCE AVE FORMERLY 0420 WEST MAIN STREET �� r T 3 � � y O -�--:. .J 3 ,,n�n V" N Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 ` 11/10/18 Brian Florence CBO O: o Town of Barnstable Building Division 200 Main St. _ a Hyannis,MA 02601 crr RE: Insulation Permit B-18-2943 r Dear Mr. Florence: This affidavit is to certify that all work completed for 420 West Main Street,Hyannis has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, ` William McCluskey• n Town of Barnstable •« :9AI-.W"1�.6S"sT A9•6.1•.6,.7p. g]A(I �.ss.'"'i}vfi"yni�cv,a pa..lt wel<,n.t._.s xp u�e'..,c�t.,tnoar na,aH-,.wa*�s,..�:?:-B cree n:'..M'.,.':-,a-xd,e.""'"wfi>'.,m_�. 'N k; gw!kt�1-'=^r- .axsaz. rot,'beu d-"Ou��cm'"c`_u„pie;�d un,, tilx,a F��:in,-a 1I<"-in.s`p.'e'xct t C�oarµrr dh raM,s`''u�b',s-e:-t'"�e bneeY,':m''K 4 Building Cad aem. ety 0O #TU Permit - stenti Cet of Occupancy is Required,such Buildm shall Noa s� Permit No. B-18-2943 Applicant Name: William McCluskey _ Approvals Date Issued: 09/07/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 03/07/2019 Foundation: Location: 420 WEST MAIN STREET, HYANNIS . - Map/Lot 269-033 Zoning District: HB Sheathing: Owner on Record: HOUSING ASSISTANCE CORP Contracto Name WILLIAM J MCCLUSKEY Framing: 1 Address: 460 WEST MAIN STREET $' ` , Contractor License CSSL-102776 2 t .r. r ? , s HYANNIS, MA 02601 G �� Est Project Cost: $3,700.00 Chimney: ;. Description: Add R-38 cellulose to the attic.Add R-19 fiberglass to the`l asement. ,1Permit Fee: $85.00 '411.� f Insulation: Air seal the attic plane and basement with expanding foam. General Fee Paid:: $85.00 weatherization. Final Date 9/7/2018 Project Review Req: :: a c Plumbing/Gas Rough Plumbing: y A :Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorize_d by ih' permit is commenced within six'months after issuance. Final Gas:_ All work authorized by this permit shall conform to the approved application and the�approved construction documents for which.this permit has been granted. All construction,alterations and changes of use of any building and structures;shall-be in compliance with the local zoning by laws and codes. - . Electrical This permit shall be displayed in a location clearly visible from access street or road and shall be mamtaned open forpubUc inspection for the entire duration of the work until the completion of the same. .a Service: qr LA � .: The Certificate of Occupancy will not be issued until all applicable signatures I;y the Building and Fire Officials are provrded'on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Health Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. p t Work shall not proceed until the Inspector has approved the various stages of construction. S Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final• i Town of Barnstable uil ' g ..� . , ',° t, . , _ � a. -�-_ " ��-° .P� r �°,: 't"b•�R med on Jo nd this Ca d IVI` _N be t� di n • Post This Card So=That it is Visible.From„Fthe Street,�Approved,,Plans1Musr ,e eta ��li a �;, r ust Kep � ,; itARN1STA�f�, * :-„•�sre!,,::-a�f�` "��.:'"5= ,..v�"� ':`� � :`"` �y�.r ,;,. ,., v^M§ �� a .� ,�„ � �.�..,..; �..y �,- 't,"�s ,y"�."'�;wx,a t u -. r, �. Posted�Until Final�lnspection Has Been Made 16sgg; , _ v �, k , ��" y,,r �Or�r,,�e' Where a`Certificateof Occupancy is Required;tisucFiBuilding shallrNot be Occupietl��until?a Final�lnspection;has been made�" ,.� Permit xS F:-.�AFY nr,:'...�W«xr; ,3i�aa:s,:;v...sla:a&ta...F.w:sktt:.«v+."at.,tW�katt:=�u+.w'�F::�s.�'.w.�i�z;�G�.pie:-..::,�.&�tiutrY:�:#:,aim-...uiewm�y.*tr:'.tw;...w.rr�tu:�M•�L�ts�.`�tiw.:.',w:kri:&.�3.,''a4..a§�Fw i'�r��.,w�.a ''4 ... Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 76 x � � � e L/ CPO BIKE Town.of Barnstable *Permit Pr l Expires 6 months from issue date Regulatory Services Fee BARN rnsr.E Richard V.Scali,Director . f S z@4 Building Division . - Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 p gg��, 13 STAU www.town.bamstable.ma.us Office:V 62_ 038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Cj 3 Not Valid without Red X-Press Imprint Map/parcel NumberQ� 1 G , Property Address 0Q) ,f(c t h 5 T ►f n i 5 [[Residential Value of Work$ '1Y60. 0 D Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address f't-ed B 19re,4re i/ (��• o arr�5 f� �. CI�I�. 6"L�.-tom'� , Contractor's Name �� kI f h Coe J� Telephone Number SM- 775.-7 Ka-3 f/fcl�CoG�32,/@a Home Improvement Contractor License#(if applicable)J(rp`9() 7 Email: �; , Construction Supervisor's License#(if applicable) 6 7 9 4Workman's Compensation Insurance Check one: El I am a sole proprietor ❑ I am the Homeowner . [�I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# 2 EJ/b Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ t(check box) [� Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to .54- f Exco y . ❑ Re-roof(hurricane nailed)(not stripping.-Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. + *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Prope ner Letter of Peter • sio A copy of the Home Impr ment Cont r ct ics�ense&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 The Com oyriveah*of Massachuseffs Department oflWast lid Accidents - -- Office o,f lmles ntions 600 Wash-ngton Street Boston,MA 02111 wnw.mass goildia Workers' Campensat an Insuraucae Affidavit:$ceders/Contractors/FAec-triciansMumhers Applicant Infarmatfon Ptease Prins:Legibly Name{�smesslOrganizationllndrri�t)_ %c� �!�l'b c-o G Ad&ess: 55 Li5a [-.owe- Wesf Oor ,5f bCe City/StatelZip: M Y 2-c y e.c,-o Phone 47 _ -7 ? Are you an employer?Check the appropriate box: Type of ecto' ,�/ - atai s contractor and I pa- � (required): 1_LJ I am a employef with_� 4 ❑ I $ 6- ❑Net,consauctiou employees{full andforpart-time}* - have hired the sub-contractors. listed on the attached sheet 7_ ❑Remodeling 2_❑ I am a sole proprietor or partner- These sub-contractors have . ship and have no employees Th 8_ ❑Demolition working for me in any capacity_, employees and have workers' 9 El Building addition [No,workers' comp_iusura=e comp_*nsuranae-t 5..❑ We are a corporation and its 10_❑Electrical repairs or additions 3-❑ I am a home=mer doing all work officers have exercised their 1I_.❑Plumbing repairs or additions myself.[No workers'comp- fit.of esm tion per MGL 12_0 Roof repairs ias,franrerequired-]T c_1.52,§1(4} and wehmmna employees [No workless' 13_.❑O.ther comp.insurance required.] *luny spp that checks box-1 mist also 511 out thee section below sbnwing&&workeie compensation polity infnrmatiob T Homeowners who submit this sffi&M Ub csting they ate damg Rn wort and then bae outside conb:xtars mist submA a new affidavh in i ts- such Cantmctors that dheck this bwi must stu shad as additional sheet shaceiag the name of ilie vob-oo zy and We whether arnot fwsa eobijm fiw amployees, If the sub-contractors ha%e employees,they anut provide their workers'comp policy uumb- I am an employer iliat 2s prmiding it�orke-rs'compensation insrtrance for my empLa yem Belau is the po&y and job site informatiam Insurance Gompauy Name: 1 rcw 1 -6-6 policy;or Self ins_Lic G_` ! to `7 Expiration Date: L /U t/G>. i s Ci �'StaW D z y l rob Sites Address: f�` U G e 5 f W7 - Attach a ropy of the workers'compensation policy declaration page(shoving the policy number and expa-ation date). Failure to secure coverage as required.under Section 25A of MGL c. 152 can lead to the imposition ofrriminal penalties of a fine up to$1,500.00 andlor one-yearimprisaament,as well as civil penalties in the fors 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 maybe forwarded to the Office of bn�estigations of ffie;D inammce coverage verification- I do hereby certi rc s 'ns thatthe irr, ormation pratided abuse iss hue and correct Sit3lature }date_ Phi if: 6-2) 7 7�r---7 7 63 ojicial use onry. Da not write in fhas area,to be completed by Gity or town official. City or Town: PermitUcense If Issuing Authority(circle one): 1.Board of Health 2.Budding Department 3.Cityfl'own Clerk 4.Electrical Inspector -15.Plumbing.Inspector 6.Other Contact Person: Phone;k 6 w Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 Iegal 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 auy 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 aibdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants — Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone numbers)along with their certificate(s) of insurance. Limited Liability Companies(LLC) or Limited Liability Parinerships(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_ Pe 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 HE in the permit/licease 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 m (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 Depaztme.at Qf Industrial Accidents Offim of lavestiptiom 600 Wasbingtau Street Boston,MA 02111 Tel.A 617-727-4900 ext406 or 1-9 MASWE Revised 4-24-07 Fax# 617-727-7749 vrww.mass ga-v1dia - P� ti � IARNSTABLE, � ' . ' ,�� Town of Barnstable Regulatory Services Richard V. Scali,Director t Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder If e 'Jjl �J, S� C 7 , as Owner of the subject property hereby authorize h�I Cif C O C"c- to act on my behalf, R in all matters relative to work authorized by this building permit application for: / o , )p /P1 % 551- (Address of Job) Signature�*64 Owner Date Print Name - If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPHLESTORMS\building permit forms\EXPRESS.doc Revised 061313 Town of Barnstable Regulatory Services °F1He r°y� Richard V.Scali,Director Building Division * snxxsrABM Tom Perry,Building Commissioner MASS. �$ 1639. 200 Main Street, Hyannis,MA 02601 pTFD �A www.town.barnstable.ma.us Office: 508-8 62-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides.or intends to reside,on which there is, or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of 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:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 f _.�Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: c � g �Registration: 165907 Type: Office of Consumer Affairs and Business Regulation Expiration: 4/6/2016 Private Corporation 10 Park Plaza=Suite 5170 Boston,MA 02116 TL HITCHCOCK CONSTRUCTION:SERVICE INC. j' THEODORE HITCHCOCK.... :..' j J 55 LISA LANE WEST BARSTABLE,MA 02668 Undersecretary Not valid wi e • 1 �1:2;558c'lUSa.ig -�.�..^8-:?:�:_ �' - .,�.�G �<:iS_'i , .. - rJ�C.�C�rrry�rroaueC! > c rJn(l' =s= =�C rc o7 3e"sielry 'eeu a iO.�s 3'_. 6_..:ca:-.s = ORiceaf'.Eonsitmer'Affairs:BcBnnipessRegvlatio,u GNOME IMPROVEMENT CONTRACTOR. :�.• . SL 9828 r egistration: 165907 Type tens... CS -09 Expiration....4/6/2014 Private Co vatic TED L WTCHCOCK TL HIT COCKAfVSTRUCTION SERVICE INC. 55 LISA LANE West Barnstable MA 02668. THEODORE ITCHCOCK 55 LISA LANE c-- WEST BARSTAB MA 02668 J,/,,...J1/ Und ccretary 06/01/2014 Restricted To: --- ------fit, License or egi'stration valid for in ividul use:only before th expiration date. If found eturri to: Office.o Consumer Affairs and Busin s Regulations' 10 Par Plaza-Suite 5170 BOSt MA._Q2.L16. Failure to possess a current edition of the Massachusetts t - State Building Code is cause for revocation of this license. f For DPS Licensing information visit: www.Mass.Gov/DPS P{valid wit out signature ' I3.i�hLtax C;;3'' I 3/28/2.014 10:05: 40 AM 1)AGI 3/000 Fax Server A<—"R CERTIFICATE OF LIABILITY INSURANCE � U3'2R201G � IRIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CEIITIFI(.A7E F10LDEfT. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR 14EGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES IJOT CONSTITUTE A CONTRACT BETWEEN 7NE ESSUIIIG INSUHEFI(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND 7HE CEH IIFICATE HOLDER. IPAPORTAPIT: If the certificate holder is an ADDI'1IOIJAL INSURED,the pnficy(ies)R1ust be endorsed. II SUBROGA 110N IS WAIVED, suhiect In the terms and conditions of the policy,certahl policies may require an endorsement. A statement orT this cerlific.ate dons nol COnief rights 10 the certificate holder in lieu of such endoisenient(s). HUB IN I EHNATIONAL NEW ENGt.AND navE: 2GS ORLEAINIS ROAD .N inx -i NORTH C.HATHAM.MA 02650 E.�'iiti s u IM1SURC R(S)AFi O;DaIG C07inr1A;E i INSL:RI:HA;TiiAVEIFHSPf:OPFgTY CASUAUIY CU GF,t,LIpJ14�c -- ----- uaur:Eo ---- fHE000RF HITCHCOCK DUA T I.HIT 933FAL 4011 III RCACT vSURc"nC. I IYANISJIS,)IA 026)t :rsunL/10 CERTIFIC QVEfIAGES _.. 9LE NUMBER• _F(.E lSIOtJ NiJHBE I THIS IS tO CFRTIFY THA'1 THE. POLK'IFS OF INSURANC'F LISTFD BELOW FIAVF REEN ISSUED 10 IHF. INSURED iNAkiLD ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHS'IANDfNG ANY RFOUIREMF-\JT, TERM OR CCNDIT!ONI OF ANY CONHIIACT OR 0-11`1EH DOCUMENT WITH NEST"EC-I TO WHICH THIS CERTIFICATE MAY UF:fSSIJFD OR MAY PERIAIN. THE: INSURANCE AFFOJADEO BY THE POLICIES DESCRIBED HEREIN IS SUBJF=CT TO ALL TFI[ i LAMS, EXCLUSIONS AND CONUI I IONS OF SUCH POLICIES.L PAH S SF(OVJN hAAY HAVE BEEN REDUCED BY PAID Cl_AINIS. — _InSR __-- TYPE OF INSURANCE AUDL SUH POLICY FFF POLICY EXP L7R INSH 1'!VD POLICY t:UC:OfJI tdlL+00.'Y1'YY t)btY1S- --- I r,11.t+OU1VYYY) GLr ERnI LtARiI nY _ - ---- _. F.ACII OCCInat C . C'Cr.^.1 ACIAL GLNLRAL I IAR9_nY - t OAr{A E 1011F1 TFD ..1CLq..IS'.-ArF t I OCCWi P.l ELLCS.tGa u.�.er r{•)---a___ . IJ _ t.IED EXP(.Cltj :I:C; •Itiu:) f ------- PL W301"AL.&AUV 17:.!11.•lY b_--^_ i GEt:EHi.L AG HFGA7G G'=1YI A(-.(:I:EiATE U§IIl AuPI IF.S PE n: -- - _— PrIU. Pn Ctk1CT5-CG:"P.C?F --i AU7 OI.!ORILC LIABILITY ..._ �...___ --- crivuirllu rccl.L Llrur - ,Ar;'fAU70. {t;y ar,4iFhld ALL Cv:rrED � SCIIF niII.F.D 1 _ _— • —:dnOg Alt1(TS - BODILY RIJbHYIPCI aCC'.In:I) ' wRUD AU7lJS AL:70S r(i 0?E R�Y GA L+S.uF cAl —- IIIIRHFLIA LIAR -- -- - c orrun '- - — T'ACII'X.C11uTE-r c L F XC.f:SS UAB CI AIMS 'AIIE - .. - ; AGC'1LGAlE - DED Viol!KERSCOt,1PEiISATIOtt -- --- ----- ANOCLiPLOYE115'LIARILITy y 1"1 1 S7ATU pi/t• ANY PROt'MI I0H6 AHTrt EtVCXECU71Vt ER - oersana.lr,uocrEXCLuotut �t:tA A-FACIIACCIDCNI A1,000I,G00 03-26.2014 03-26-2015 -- ---- '1'1'�.t':+'.nh:•wdel 2.I,:1D iG44 U F.5t;NIPT16n OF r' E.L.?ISFASE-EAERIPLDYEE SI,lao.q.030 pPEn;IftV5luPo YEL �ISEAS� FOLICUS--- �1,CCQv%0 1 UCSCNiPnntl OF OP� O RATIONS/1- CATIONS I VEHICLES(Attach ACORD Int.Addilianalllomrrka Sctedule,Itmetaap7u.>is Fit'ICIiC(.lCk,THF,OD'JHE is rovo:ed 6y Ihu Y:u(knls'compensaliun policy. I ,CERTIFICATE 0ER CANCELLATION 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES UL 1 CANCELLED BEFORE THE EXP}HA710N DATE. THEREOI-,I NO110E WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AunionrzE-T7 nFrRESEr;TARVE AGORD 25(2010105) The ACORO natne and logo are Tegiste ed9markslof ACORDGORPORATl�N.All rights reserved. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r Map Parcel Permit# 6 0 Health Division Q� Date Issued Z�' G-� 6� Conservation Division Application Fee >��• Tax Collector Permit Fee Treasurer Planning Dept. CONNECTED SEWER A Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address /alb _13)4-loaou Village `A c Owner Address J00 Telephone 0 9-- 77Z0- �Za O Permit Request ��i'44 O4L t�lL f f>/� S�Q e-- Square feet: 1 st floor: existing DSO proposed geD 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio Construction Type Lot Size Grandfathered: ❑Yes LJ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ; 'No On Old King s Highway: ❑Yes �'No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) .. Basement Unfinished Area(sq.ft) i Number of Baths: Full: existing ® new 0 Half:existing new Number of Bedrooms: existing ei�9 new Total Room Count(not including baths): existing l new First Floor Room Count Heat Type and Fuel: �4r/Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes U'No Fireplaces: Existing 6 New Existing wood/coal stove: ❑Yes XNo 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 Ian review# Current Use Proposed Use J�t/�✓"`�" G �`L%� BUILDER INFORMATION Name Alocl Telephone Number Address 2, License# D-?y 9e �5 �• �� i Home Improvement Contractor# D 3 O 2 S Worker's Compensation#?ao ll - jDLY�Ioy IfD Z- ALL CONSTRUCTION DEB IS RESULTING F OM THIS ROJECT WILL BE TAKEN TO SIGNATURE DATE �Y. 'i�� FOR OFFICIAL USE ONLY n PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS - VILLAGE OWNER • i DATE OF INSPECTION: ' FOUNDATION D� of FRAME �j / � K �� iz— INSULATION P g S FIREPLACE i C'3 ELECTRICAL: ROUGH ® FINAL - PLUMBING: ROUGH Ci / FINAL ET? . GAS: ROUGH '� FINAL m FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. • r { R `-� The Commonwealth of Massachusetts ; Department of Industrial Accidents MhefOP910 600 Washington Stream < Boston,Mass. 02111 Workers' Co ensation Insurance Affidavit-General Businesses address Z� / ci state :�s •�,7 one work site location(full address ❑ I am a sole proprietor and have no one Business Types ❑Retail❑Restaurant/Bar/Eating Establishment . working in any capacity ❑Office[I Sales(including Real Estate,-Autos etc.) ❑I am an ens to er with ens 1 es(full& art time). ❑Other �%��/1fNmi��yi.,!W111.1//�/% Densa� u foremplo� I am an employer providing v�r rkers' mpensation for my employees working on this job. com an name: +' , . '�5• .'• hone#••`. `:-��'' '' '�� . city- I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: com 813 136me: insurance co. comp any Daiiii .'!!`'`'' •M1. .. •• - - _ address: : .. hone#E citu •;:' :. ''� :'•tiff �'OZ1GV•# .„ '';. '.r fiisur'enceco.::r•'.•;.�••� `.;' .4:•'•• .:.r' �:•:..�:•�:::,,,:,<:.:, _, ;;• �, .,:,':'' •: ' .:: .•...•... •: ' ::• '°'� �. Fallura to secure coverage as requited Hader Section 25A of MGL 152 canl d to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years,imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me- I understand that p - copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification I do hereby c under t e pa.-sand n ties of er ury that the information provided above is true and-c rr Date signature �� Phone# � Print es r ri t name ' `q ' oiHcial use only do not write in this area to be completed by city or town oflleial permitllicense# []Building Department city or town: OLicensing Board ❑5electncWs Office ❑check Uimmediateresponseisrequired ❑EealthDepartment , contact person phone#; 00ther (revised SepL 10M) Information and Instructions Massachusetts General Laws'chapter 152 section 25 requires all employers to provide workers'compensation for their employees. As quoted from the"law',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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth.for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 mpenPlease fill in the workers' cosation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the -. affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being Should you have questions regarding the `law' or if you are ustrial Accidents. S aIIY qu g ent of Ind Y requested, not the Deparlm required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill.out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will b'e used as a reference number. The affidavits maybe returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would hke to thank y'ou in advance for you 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 an of le S998dons 600 Washington Street Boston,Ma.. 02111 fag#: (617)727-774.9 phone#: (617)727-4900 ex:L 406 - oFTMe r� Town.:of Barnstable Regulatory Services v Ma u.$ Thomas F.Geller,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.townbarnstable;ma.us Office: 5-08-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder et ,as�bwner of the subject property hereby authorize to act on rnybehalf, ' in all rriatters relative to work authorized by this building permit application for: (Address of Job) + v Date Print Name COMMERCIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $150.00 Alterations/Renovations $100.00 Building Permit Amendment $50.00 FEE+VALUE WORKSHEET NEW BUILDINGS square feet x$140.00/sq.foot= x.0081= ALTERATIONSIRENOVATIONS OF EXISTING SPACE square feet X$96/sq.foot= �0 X.0081= /,:?/. S d` STORAGE BUILDINGS ONLY square feet X$32.00/sq.foot= X.0081 Commprojcost Rev:063004 • � � �l e+-Po.rvnzonu�ea�C o�✓�.Czaaaclu�aek6 Board of Building Regulations and Standards HOME IVEMENT CONTRACTOR Re 1st_ 103690 006 NEAL A.PRATT f ea Pratt 42 Chase Rd r'�.4 ✓ . E Sandwich,MA 02537 Administrator SGARD OF SUILDING REGULATIOAS - License. CONSTRUCTION SUPERVISOR fl Numlber•`V 030908 �I Tr.Ma: 94,63.0 N,RA-L A PRATT = _ 4r2.CWSiE A =RDo-v ti E SANlb ICH, -`-` I Admmistrator V HYANNIS FIRE DEPARTMENT {YAkNI, y s 95 HI O GH SCH O�� L RD. EXT. H ANNIS, MA.02601 erN�r i:� HAROLD S. BRUNELLE CHIEF ��F'�FFMVITtE�1 � fTUOE{T�YAREMFi{Of i1RE EOYCAipM FIRE PREVENTION BUREAU BUSINESS PHONE:(506)775-.1300 FACSIMILE PHONE:(508)778-6448 LT.DONALD H.CHASE,JR.,CFI LT.ERIC F.HUBLER, CFI FIRE PREV1t✓NTIOiV:OFFICER. FIRE PREVENTION OFFICER BUILDING CODE COkV]PLIANCE FORM THIS FIRE PREVENTION BUREAU.HAS REVIEWED THE PLANS DATED, FOR THE PROPERTY.:LOCATED AT -. iN ALSO KNOWN AS THE .CHART BELOW INDICATES THE STATUS OF OUR REVIEW: TYfI:OF CfdN$TFUCTIQN DC3tUMENT N/A RECENEO REVIEWED COMPLIES 1sNARRATIVE. tEPO.RT 2=FIRE EIGHTtNG!IfrCUE ACOESS. .. 3 HYDaANT tOCATION/WATER SUPPLY; 4=SPRINKLER TI*'SYSMS 5- PRINKLER.CONTROL EQUIPMENT -.6=5TAN &SYSTI=MS 7=STAN(3PIPIE I,VE:LO -ATIONS . 8-FIRE:DEPARTMENT COItIIECTION §-FIRE PROTECTIVE StGiN-6 NG SYST. 10 F P.3:S &ANNUNCIATOR LOCATION: 11-SMOKE CONTROL/EXHAUST 14 1 -SMOKE CONTROL EQUIP LOCATION , 13-LIFE`SAFETY SYSTEM FEATURES 14 FIRE EXTINGUISHIfUG SYSTEMS :15-F.E.S CONTROL:EQUIP LOCATION 16 FIRE.PROTECTION ROOMS 17+IR.E PROTECTION Ef1UIP SIGNAGE 18-ALARM TRANSMISS!ON METHOD 1.9-SEQUENCE,OF OFEfATlON REPORT 20 ACCEPTANCE TESTINGCRITERIA .: WE BE UM NTS T E COMPLETE AND COMPLIANT FOR THE ISSUANCE OF A BUILDING PERMIT: WE HAVE GOMPLET THE ACCEPTANCE TESTING FOR THE OCCUPANCY PERMIT AND BELIEVE THAT WITHIN THE SCOPE OF THE BUILDING PERMIT,THE ABOVE ISSUES ARE IN COMPLIANCE. r•� J J E f J i E a 0 '•A _- S' Z �spincs sririfnA window w/ r 1 -4 7elnmrWP-4 �n Andarsano;W 2 1 e a •• O ra O Andsresnw AW 2 1 - - 7},srmwTroPG 1 B 4 9/O' J 9'-e l/4, I S'-O I/Y" •M rn �o Andar anoAW4I �' _ - II Ott A•darcana•AW 4 1 A-O• w E EP 11 ��-� o.2'O'i/0'r Y'Al/0' - Andar nmTW YOGY I' r � r oeE �k r.o.Y'-Io1,0•rd.'-A,;B" r Q 0a f e f v S iA�£e o i Mc b a f n f ;�t g z bad _E— r-r 3 n - - U ------ - --- ---; --- ----- rn � S s \ Z p rn • -v r Z N Copyrlght 62005 by Kenneth Sadler Alaaclatc>: rROJ1=GT: New affiza Arook LaYou4 for: Fth TH hAr�L��`��•ceccedunderFederal Pr ieC alonal Building Designeropyrl9htLr o.J t #1619 / / / / {�toconseructoneendonly IjOr\ /• A�:/1/TAN` C eOP-1home ti gthlspl nModlFlcatlonor lJreuse Is prohibited wltho t express writtenpermissionoftheDesigner. n`rid/dnd/mrenb�Q�ATION: ughtt t„ tt titan af....:I�ennei li Sadler Assoaakes a..rac ttr-o nr<mmc narPiwn oYB/osP a,e toPrshminwryP1 s t c is Pr«dh wlche oMti[C 9the acceptancebuilding designTsaisd Ploor Plwne wnd h,+arior.4./7/Oar llA9•ayamle MAa ,rE:BIQenLl 1 ,ymni•S,. A sdow to MY Ofthlan rvfessienalmmerel there>ponaPo4ltyafthe '026O1 508190.5 e7] - gcoMr:C r. s t i keadlerokeadesigncom•www.ksadeslgncola.; > @ S P �;3 A 411, I� cn orn i ` r- 2 3.° f a ---- -----heWc i J mi- iT -L J-- EL n� -u •, ................ I.°nlayeq°°q b°ok.haWo'• ------------ 0 El 1 — 9 3 7 . DRAYVN BY:_.. N Copyright a]00a a protected Sadlar redealates: PROJI=GT, x Thesepinnserep oc aedanderFeeera --.-... NeW OfflGeaC6A LAyOU'I'for: ILEIyFyCTN hf�fJLG[=.1�. 0opyrlgh[Laws.The original purchaser of this Pry jeet # 161 9 - 1 S s plan Is authoritedto construct one and only /I ProFessbnal Building Designer one sprohholne using is puntwithout .alflexpresti—s t N z reuse ispertn ion without expre»written 3C permission of the Designer. > t. t Any di>crepart:ba,ercar>end/or oml»b an �I @ hgs wn alned on Ne>a dorrrm.— O L .. r enn_eth Nadler P>sscuatkes LOCATION: d.w REVISION$: shallbe br ughCL the attention of @ PralinKnary Floor Plan.9/96/Oes the Designer priorh. the ommebummt O refesslenal buildin desl n I CJ LAFt'AnGE al Gana tlpaM1 P O e—pth Sao»adf lo°r play wnd I,#ariorr 4/WO3 p 8 B caroauetlan d ue to the seeaveanee Con.+rvuion Plan.a/si/05 6OmmerGlal•residential HyAnnls,M of the do—ants maay b>cr epanG rr n nd/ar amla>loro i PO:Box 114g•Hyannis.MA o2601.506.7g03 g00 • beaameN e>ponalblllty of the ..-i.....:......:ksadlereksadeslgncom•wwwksadeslgrtcam ......_...i.- bWlding cmrc��ncear. 1 5 A s C E A O s r , 1 0 V a s I 0 I ppp P >L P P f 0 3 p lP 1 eopyrl4ht.20051,y Kenneth SadlerAssocl9[es: PROJECT: tr I,r DRAWN BY: S These plans are protected under Federal q N,w Office AreA LA oU4 for: copyright Laws.The original purchaser of this Pre Je Gt # 16 I: 9 Y- NN�TH�JAfJLG�.1�. }�. m plan 1,apch.11-dtp construct one and only Professional Buliding Designer I one home usingihls plan Modification or 7 reuse) prohiblted without axprass written �OU�ING �ahh��'ryJSel�liE GO�p 3 S perm)»Ion of the Designer. _ . O A S .. _ .. _ Any elsoepeKL'>.errorsane/or Omissions LOCATION. nehernteh.d. on>end or Rev15lON5:' iGenneth GJadler f44�oGlatea d,Hg a h,to the 4tetion of O 1 ehesigne ought to the a'.tentlon of ✓j' r to the Pslimnfry Plnor Pl..na.9/YO/O% .. I L'LiFrAnGe the of co cuclle,oceeding with�t g eyiaad PleorP n.n dlnrarwr.4/%/Otl prefesslonal building deslg eon on,litute-ne—p—ce ... eon.+ruction Pawn.4/g/Og ...i...-i commercial•reeidentlaf n emni d,,MA >vucnonc of these documents and any i on ro�� a>crepanciea,erc and/o missions P.O.Box 1 14R•Hyannis,MA 02601•506.I90.9 4]3 become the reapanalbllity of the :- - -=kaadlCYBk9adC>IgRIAm•WWWK,adG>IQRCORI� -- - bulldingwnlZactor. I ,. e �: _ boo a Li 0 w; _ f i6 f 1§z , .itorwgc �g work I e r.hl. I� - ____...... .. .__......_._.._._. 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