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Home My WebLink About0096 WINTER STREET �B�T� f%Itllisl+ 91�� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3CJ I L Parcel � $S Application # • BUII�DIN� D�p�; pp Health Division Date Issued of "/tP f X Conservation Division FEB 16 2016 Application Fee Z4 N Planning Dept. TOWN OF BARNSTABLE Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 16 Q;A-tr r -:6 Village Owner ►'Ic ar5pes5 Address atw Telephone�5D 9- �uT�039 Permit RequestE4f.6A 5�6", ) o e . lZ ruskLe re, dne r 1 Cc r En�-IVew llixy 154 J Square feet: 1 st floor: existing 70 proposed O 2nd floor: existing 1proposed Total new 976 Zoning District (3/4 Flood Plain Groundwater Overlay Project Valuation&000 Construction Type woo� 44me Lot Size 0,3 acrcs Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) 3 Cc�pa�VS0 ) Age of Existing Structure /10 Historic House: ❑Yes J4 No On Old King's Highway: ❑Yes )fNo Basement Type: )d Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 670 Basement Unfinished Area (sq.ft) YSd Number of Baths: Full: existing new Half: existing !3 new C) Number of Bedrooms: existing,l,new Total Room Count (not including baths): existing 7 new First Floor Room Count 7 Heat Type and Fuel: ❑ Gas X Oil ❑ Electric ❑ Other Central Air: ❑Yes XNo Fireplaces: Existing A New Existing wood/coal stove: ❑Yes 0 No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:)d existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: isil►,ca rue- CVAvef Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review # Current Use 1"ile FqMAV Proposed Use 6-�& Fi_oi`V APPLICANT INFORMATION (BUILDER OR HOMEOWNER) -- Name rriL 9.t rSncSS Telephone Number Address SAY Ad License # r✓i �� , Home Improvement Contractor# AftlWi Email C11COu ezLLr5n&ss. 69M Worker's Compensation # EA 66L13076 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PRO ECT WILL BE TAKEN TO Servile,e5 i-A eV' SIGNATURE DATE C- r r FOR OFFICIAL USE ONLY APPLICAtION# DATEIe9SUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION FRAME 6 INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Client#: 761906 2ERICBA ACORDTM CERTIFICATE, OF LIABILITY INSURANCE r DATE(MM/DD/YYYY) 4 12/03/2015 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,EXTEND 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(ies)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 - - NAME: Dowling&O'Neil Insurance Ag PHONE. 508 775-1620 FAX 5087781218 A/C,No,Ext: A/C,No 973 lyannough Rd, PO Box 1990 E-MAIL ADDRESS: Hyannis,MA 02601 1NSURER(S)AFFORDING COVERAGE ' r^ NAIC# 508 775-1620 INSURERA:Essex Insurance Company_ INSURED 'INSURERB:Guard Insurance Group E.A. Barsness&Company, Inc. , 54 Angus Way wsuREg c: r Centerville, MA 02632 INSURER D: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY 3DY8576 04/16/2015 04/16/2016 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISESOERENTED nce $50,000 CLAIMS-MADE F OCCUR MED EXP(Any one person) , $5,000 X BI/PD Ded:500 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICYEl PRO-JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR ' EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION EAWC643076 09/2112015 09/21/201 X WC YTUMI EOR" AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $SOO,000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Insurance coverage is limited to the terms, conditions,exclusions, other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended,the coverage provided by the policy provisions. - y CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BuildingDept. ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD 40C 494 OA n 1RA4 A4010 1 C4 - ?Tiz Camn-tomvealth of Massachusetts �eperr'trt�e�st et»��'ixc�strial Accid�rts - . — -- t?�r�a�.£ris•�tigt�ctirs. 600 F7as,�iziigtoxt,S`t eet Barston,__MA 02M mvts:masmgtavldia Workers' Cumpensaf anIusuranceAffidavit:$,uitdersdCuntrac-turs/Eectricians/PFunbers Applicant Inforrn.atian Please Prim Le:�ibTY Name f! A f ✓ rs Ressq- Ca lr�.. ,.% A ho*U�S 9� L CLty1� t3 3= t✓/vY �f� lCS n C 60 AL'eyau an employer?Gheckthe appropriate box: ' Type of project(required-)c 4. I am a general.confractor and I 6_ New consfrucfsorL I_ T am a emplozr urtfr �.. ❑ ❑ employees(fuf aud(orpart-time,* have hired.the Sub-contractors 7_❑ I am a sole proprietor ar partner listed on:the attached sheet 7. ❑Rz odeltng F ship and have no employees. These sut�-con�ractors have 8-•❑Demolition wording forme in Bay capacity: employees'andhate wo&ers' p �`(�uilding sddifiorr Jmb n-art', camp_insurance comp-insurance-1 .$ Pam' re hired 1 5, ❑ We are a corporation and its 10❑Electrical repairs or additious 3-❑ I am.a homeawn:er doing all u�orlc officers have-exercised their 11_❑Plumbiagrepairs or 3:d3itions k of ea per M.GL ' inset€[No workers'tip_ � �fiou p 11❑Foafregairs • . ;nenrarire re aired j[ c.152,§1(�,aadw,�e lave no 4 - employees.[No woAers' 13.❑Other .. comp_msmanm required_] *Any apptfcsattfiatchedcsborflmastalsafiIloutthesectimbeiuwsho ingdLe¢suoderecvmpmsatiaapaHr_yiu5=runa3_ #Sa�oa,a�rsurho submit dais sf5da<<u iur�catiag they aZg�aiag allwa¢ir Shy t5e8hix2 a•utsid�rrmfrvr[nFSmnst submitanewa!ndast T^�'�snrF , FCantnact=ffimt r}�ecYtlrFs bmi mast rttachetl sm additiaasl shed sboniag tbe'nams of the mit?-coutsctag aad state-whether.or not tbase eaddu bzve e�3o32es.IftbesnTrtoatactncshace empioyt�s,tFiegmustgm�dethetr nvrkexs'comp.paIic�aumher. I curt an errtp7crr tlarrt i�grat�idu �r�arIers'conrtsrn`ture insrirartca�or arc}s encpla}�ees $etvsv is:t7�e paliry rutd ja�aa ' irr,�arrnrrtan . Insumnce<Company rime: A /'L �a„ • Policy or Self ins_I ic_, ..�lT C b 4 30 76 Expiration I]ate: 1 , Job gite Address: /(Q IA/1&,c , Ci:y/ tatet .rp:#Va An is, Attach a copy of the workers'coaapensatiatt"policv declaration page(showmg the policy number and esphmtioa Sate).; Failum to secure coverage as requiredunder Section 25A of MGL c�157 can lead to the imposition of rsimTral penalg s of a fine up to,$1,500 00 andtor one-yearimprismtmwt as arch as civil penalties in the form of a STOP W.ORK€RDERagd.a&e of up to$250-00 a day against the violator_ Be advised that a copy of axis statement maybe forwarded fn the Office of Itavestrgadons of$te DIA for ibsu=e-coverage vadficati a- I da Ftereliy cerrlif��nab tFter prtirt�artd psrtaI�ris Far�url'�atfite ira;�arrszaiimr ptm ded abm�is bars artd correct Sitnatore: T1 A c A Pry S ll/l efl pate ` �•� l Phone ,r Ogk al use arty: ,Da aril o-t nta Eft tFtfs axed tit be crrrnptetcsd b 'ctrtQt��n ct frcutt City or Toga: Perniif .&ease# Issuing Auffiority(idrele one): L Board of Elealih I RuMing Department 3.drown Clerk 4.Electrical Iuspeetor S.Ptrrmbing Inspector 6.Other Contact Person: Phane#: L - arm ation and Instructions, ; ` ' Massar_-hn=its CTcb=-1 Laws cliapt=152 regnaes all empIoyers`to provide compensation for tbeiz=Ployees- p tD this stntab,-,an c2-!p,aye=is&fue:d as_'.=M:yperson in ff a service of another under any contract ofhire, eaPress or inIplied,oral or w ten An.Mayer is di--fined as"an mdrvidaal,partnen;h�p,asso®fiUA corporafion or other legal eatdy,or airy two or more Of the foregoing a ngaged m a Joint enterprise,and including the legal regresenfa&c5 of a deceased employer,or the receiver m trustee of as individual,pa txmmbip,association or o$ier Iegal entity,employing eu�loy - However the owner of a dwelling house bavmgnot more than three apartments and-who resides therein, or the occ¢pant of the - dwelling house of another who mapIoys persons to do mafiat an ce,construction or repair work on such dwelling house or oa the gm-Lmds or bmldm- g app�tliereto shall notbecanse of such employment be deemedto be an employer." MGL chapter 152, 925C(6)also sues that"everystafe or local licensing agency shall withhold flie issuance nr reaewal of a license-or permit to operate a bIIskess or to constmct btu[diags in the commonwealth for any applic-antwho has notproduced acceptable evidences of c6M)?H nrwitlr the ir,cQran_ce_coveragerequireas shall Additionally,MCTL cbapt er 152, §25g7)states Either the-coo: ,�,onwealth nor nay of its political subdivision Mtex jotD any contract for.the,performanc6 ofpubho work until acceptable c-idence of compliancevlith the Ins rranCS- req�enients of this cbap�_have been pizsenfed to the contracting antTioiziy." r .• , Applzcanfs . . Phase fill oil the workers'compensation azT adavit completely,by rhecl $e boxes that apply to your situation and,if necessary,supply sub- ont-mtor(s)name(s), addresses)andphonenumber(s) alongwiihtheircertificafe(s)of ;ncnTance. Limited Liability Companies(LLC) or LimitedF_iabU Partnerships LP withno employees other than the members or partners,are not required to carry workers'compensation insurance- If an LLC or LLP does have emrl es a o c- yis � Be advised ffiat this affidayitmaybe submith--dto thr Department of lndn al Accidentsmrcon-EErmationofnsurancecoverage Also Be sure to sign:and date-the affidavit. The affidavit should. beretamed to$e city or tnwnfliat the application for the peanit or license is being requested,notthe Department of Tnrh.ctr71 A�cidmts. Shovld.you have any questions regarding fie law or ifyon are regns-ed to obtain a workers' compensation policy,;please call the Department at:the number Hsf�d below_ Self-insured companies should enter their en self-ins=ce license number an the appropnatr line_ City or Town OfQcials Please be sere that the affidavit is complet$and priced legibly_ The Department has provided a space of the bottom of the affidavit for you to fill out in the eymt the Office ofInvestjg'afioas has to coxdactyoumgardiqgthe applicant P lease be sure to fill is the p enni Ylicense number which Wi ll be used as a reference number. In addition,,an applicant that must submit multiple penDWHcense applications is any given year,need only submit one affidavit mdicatrag cua-eat policy in fomalioa(if necessary)and under"Job Site A'dress"the applicant should•Pr'itc."all loch ns is (city or town)-"A copy,of the-affidavit ffi t has been officially stunped or marked by the city or towi may.be provided to the applicant as proof that a valid affidavit is on file for fdMI 'pemits or Hcemses_ A new of a- avitmust be imrd of t each year.Where a home owner or citizen is obtaining a license or pP,m2i not related tp any business or commercial veutLu e. (ie. a dog license or permit to bum Ieaves etc.)said person is NOT req�d to complete this affidavit The Office of In os-Would Ike to:hank YOU m a&m=for your cooperation and should you have any gnestions, please do not hesitaiz to give'us a caM The Department's ad&=.,telephone and fax number: C.G=j0nWe3jthE of Massachuselb Depzemmt ofladustialAcoidents • � 6�4 man Sit - . , • Bagto-n,YA 02111 Tf,-L 617:-' -- ext 4-06 or 1-M MASS.AFE Fay#617 727'749 Revised4-24 D7 VM9qgIdi& TRErgy Town of Barnstable' o� Regulatory Services � txetnucr•�txry F , mass. Richard V.ScaI4 Director Building Division v Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 www.townb arnstable mans Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, ✓:c Q �Sns , as Owner of the subject property. hereby,authorize _.Z4. &rmers*-6,.J c to act on my behalf, in all matters relative to.work authorized bytbis building permit application for- liann iS (Address of Job) Pool fences anal alarms are the responsibilityof the applicant. Pools. . are not to be filled or utlized before fence is installed and all final. inspections.are performed aad accepted: + Z� c res 91 rttt Signature of Owner Signature of Applicant I L' CiG. CS rieS�. &(( Pc ZPres-d en� Punt Name Print Name Dare : . QFORMS:0W=ERMMSI0Ie00LS P •Town of Barnstable Regalatory Services of rchy� Richard V.Scali Director Biding Division RaNsz•IMS Tom Perry,BuuZding Commissioner 9 a�I&A SS 200 Main S� Hyannis,MA 02601 www.towa.barnstable_ma_us Office: 508-862-403 8 Fax: 508-790-6230 HOIYMOWNERUCHZQS EXF.IlIYTTON •P[rascPrint DATE: JOB LOCATION_ number sit ° "30IvIF.OWI�R: • name "home phone 9 work phone it 7 CURRENT N AH.NG ADDRFS S_ _ city/[nwa sty rip code The current exemption for`homeowners"was extended to include owner-occupied dwellin u of six units or less and to allow homeowners to engage an individual for hirewho does not possess a license,provided that the owner acts as supervisor_ DEFINITION OF HOMEOVn FA 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 struct:dcs. 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 shaH be responsible for all such work performed under the bnldina Dermit (Section 109.1.1) The undersigned`.`homeowner"assumes responsibility for compliance withthe State Butildiog Code and other applicable codes, bylaws,roles and regulations_ - y_ The undersigned`aouneowner"cm- fies that he/she tmdersrands the Town ofB amstable Bwlding Department minim=inspection procedures and requirements andthat helshe will comply with said procuhn-es and regaimmeuts. Signal=ofHom=-%ncr Approval of Building Official Note: Three-hMily dwellings containing 35,000 cubic fEot or larger willbe required to comply with the State Building Code Section f27.0 Constriction Control 1 ':E[OIYMWNERIS MMAWnON •' 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_I 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 Superviso'rs,'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 acing as Supervisor is ultimately responsible. To ensure that the homeowner is filly 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 formleertif c ation for use in your community. Q.\wpFI7_ES'IFORM9Vn lding parmh fi;=lEXFRFSS.doc Revised 0 613 13 I_ r e r. Massachusetts Departrne-r t c f Puiadre Safety !"Jig 8barrl ofBu{idrng Regu4airons and Standards`-' Construction Supervisor License:C&-,079A03 Restr'rcted to: r nstt ac1'it3n S.,ixr r°v isc Uhrestricte& Buildings of any use group which contain" "^ Iessthan 35000 cubic feet(899 cubic meters).of enciosei ERIC A BARSNESS¢ `' space. 54 ANGUS WAYMEN : CENTERVILLE MA (# ` QA - t7Cr,falO�i�,: Ccrrtsn%issioner 08'27t2417 Failure to passes a,c#wented,rtron pft-he Massachusetts State°�Buddirtg�Code is'cau'se€or revocafron o#--t#iis license. DPS:Lrcensing r"nfomnat' n visit VVWW.MASS,GOVJDFS C}t ice of G.ans�l,rriel A`ffalrs g lad I3.`Is)nes,s R—tdatiarl w 1(} Pal k 1'Ia7a Suie5:170' Rstoil ssachus tts 0�11:6 I0n1e l)mprovenwnt Qbhirac tc r Reg s1,r P-1911 Fteq'istratacn: 1490f8 Type Privote;Corporation E=zprrtron,� tIEf2(}18 E,A_,BRssS �:co , rNc: E E�RfC BARS_NESS 54 ANGUS WA CENTERVILLE MA 02632` _..... ,+ trptlate�#dciress and reiurn card. Nlirk reason f6r change:. w. Add i-" Re€ic� al L mpia�ment F ost Ezr'rf, � r>">".� � � T�e;i ors ri�.•.n f�+.,.t�j �F ,•;1,�(' . - - t 1 r�erase ar.regis"tr'ltion�'alyd fcir indiviciirE;use.nnl�t' Office of Concu3ner Lffarr5 Bssiness tLrgulahan, "rF�nItOME iMPR�OVEMNT CONTRACTOR before ihe cxpiratron date if fou,ud i eturn to Registratrfln; 14;g78' Type;.: Office=of Consumer Affairs and BusRegulation Exp'sraUon: ..; J6 218 ' Pr3rat,e Ccrp4catror; CO Park C'laza=5urtti+Y'0; r 13os(on,M.A p21 .Tfi 'CIC:' t ndersrcrat�ry; riot witiid avittmut srruni tune - T r- 4 • * ,d_ a -i - 2 ct Si f o i 4 .: • { All :. s. i n r n - - ..y..,._:. .a..+..;Y..V n +s' ..,��r � r:• y r,;nr � ry. k h �, Y' •,,�t TP e.. r ..p.:,,;. x ..��:. w 1 J.,...., ..._. 7 a v'r a ; i 1 I I E r1 I I' I- I� � h—I. ( , �.— I I `i. I ' � •1�'�/L I�//�— _j i ---r' -r— i -I � .. 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I i_--_'-�_-•i I i i• _-� j -r_- _ I i '- I -- 11--_^T_.�- i --r---�--j-- -1-- , I j ! — -- --- -- ---- —— r I ; , I I j ci ° I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION q Parcel �s BUILDING DBPT. Map Application,4d Health Division MAY 17 2016 Date Issued V'2-7' � (40 Conservation Division TOWN OF BARNSTABLE Application Fee Planning Dept. Permit Fee P C-D Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis evt�r w�t� Project Street Address Teo Village gu&nNO Owner &Glez Address a V Telephone & - qyq Permit Request A Lx G ns i 4.,-0 r �Vko-.0efM,-4--Jt 1-k (Ocse_ 011- b�� W` 1 r Square feet: 1 st floor: existing �U proposed i606 2nd floor: existing proposed Total new Zoning District 0 A Flood Plain Groundwater Overlay Project Valuation 35Da O Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.,' Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes A No On Old King's Highway: ❑Yes ❑ No Basement Type: ,Full )tCrawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 3 existing knew S_ Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas A-Oil ❑ Electric ❑ Other Central Air: ❑Yes gNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION �_` (BUILDER OR HOMEOWNER) Name �1L �CA — Ca Telephone Number JI—M-f I Address UA License # 72W 1 e rl 0o -71 Home Improvement Contractor# Email erl P.Ct bars h 6&S, Worker's Compensation # E WL1 T3 l6 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i h SIGNATURE � ��' '� DATE w FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. r ADDRESS VILLAGE .`OWNER DATE OF INSPECTION: FOUNDATION ti F FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 6PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. x Lmenra: 1151 yub 2ERICBA ACORDr. CERTIFICATE OF LIABILITY INSURANCE ' DATED/YYYY) - 12/03/203/2015 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,EXTEND 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(ies)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 CONTACTNAME: Dowling &O'Neil Insurance A,g PA"I°NN,EXc):508 775-1620 'A No): 5087781218 973 lyannough Rd, PO Box 1990 E-MAIL -- Hyannis, MA 02601 ADDRESS: _ 508 775-1620 INSURER(S)AFFORDING COVERAGE NAIC# . INSURER A:Essex Insurance Company INSURED INSURER.B:Guard Insurance Group E.A. Barsness& Company, Inc. INSURER c: 54 Angus Way Centerville, MA 02632 INSURER D 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 OF: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY 3DY8576 04/16/2015 04/16/2016 EACH OCCURRENCE $1 000 000 X1 COMMERCIAL GENERAL LIABIU1l DAMAGE TO RENTED PREMISES Ea occurrence $50,000. _� CLAIMS-MADE O OCCUR MED EXP(Any one person) $5,000 XI BI/PD Ded:500 F PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - .. _PRODUCTS COMP/OP AGG- :s2,000,000 _ POLICY PRO, r JECT LOC s I AUTOMOBILE LIABILITY, COMBINED SINGLE LIMIT — Ea accident �:$ ANY AUTO BODILY INJURY(Per person). -$ ALL OWNED SCHEDULED - BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OW!VED..: . w ,� HIRED AUTOS AUTOS- - Per accident $ 1 UMBRELLA LIAB I — OCCUR EACH OCCURRENCE ,$ j EXCESS LIAR CLAIMS-MADE, - AGGREGATE $ - _ I DED RETENTION$ is - WORKERS COMPENSATION . WC YTAT i YIN - OTH- AND EMPLOYERS'LIABILITY B EAWC643076 09/21/2015 09/21/201 X .. - ANY PROPRIETOR/PARTNER/EXECUTIVE� E.L.EACH ACCIDENT 1s500,000 OFFICER/MEMBER EXCLUDED?. N NIA (Mandatory in NH) E.L..DISEASE-EA EMPLOYEE $500,000 1 If yes.describe under I DESCRIPTION OF OPERATIONS,below. E.L.DISEASE-POLICY LIMIT '$500,000 , DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms,conditions, exclusions, other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered, waived, or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD 4 C 1 R 10 A A 111A 1 R 4040 , Ric Couxuzcrravealth rz,f Va sadiusetfs Deparhnmt erf rxulrrstrial Acciderris - Office ofImesdgada=- { 600 Washiitglo Street ` Baston A 02-Ul x • }t!FY}4:ii1CiS� tTf'�dl1Z P Workers' Carnpensation Inmrance Affidavit:$udlders/CantraetursMec ricianslPh=bers Applicant Infarmafi ag —p^ Please lariat Legibly Name.(SusinesslYhganrrrt r�,�nr�" '�TRx}: 'r, A� &rs Aessq- Ca, _. &, Address' APIC4 U-S L.,U Czt�rftatefg: Are yo-u an employer`?Cfmckthe appropriate box: ' Type of project(required): ,4_ I am a eneaal contractor and I I_ I am a employzx with_� ❑ 6: [�New constmctfm employees(fuH and(or part-time * have dire .flie sub conl=arfors 7 fisted oathe attached sheet. 7- ship ❑PPmodeling .❑ ram a sale propaietor• arpartnPr- ' employees. 'These sub-contractors have ❑IJemalifica and have no�m I gees. $;.. Vodi ing- for I-n in any capacity_ employees anclhae-e workers' 9. Building.addit au jNo worTm-M. comp_insurance comp.insurana- re ed_ 5. ❑ We.are a corporation a>Yd its 10_❑-Electrical repairs or additions 1 Officers their 3_❑ I am.a hameoirner doing all u�oric ,.- 11_Q P3umbsngrepairs or additions &-If o workn-s' ugat of exezaption per MGL zrry [N. t'°anP- 1?_❑Iioafrepairs ;- incmanre required-]7 c.152, §1(4)and we have no enjpjO o workers' 13.0.Other . Yam- comp.mswrance required,Z *A-mya HCX13ttnstcherlsbarr1testaLsnfillwEthesectiaaSeTawshurongdie¢ivo>ices'compersatiaapopsyi ocma'aon M, Meawnoxwho subonFt this aifldzvn ineutztmr they am3aiag RUwc*mA then hire outside contractors submita new riadaBt indicatia_-sacb_ rcant[aCtMJEAt:ch°r3cthfe boa mast xtteched ns additinnsl sheet showing tha'n=e of the snZNcomlrx tiL and state whether or not those entities ham emP1v}Res. If them it-caattactomhace employees,they nM5rpmtidetLeir nvrkes'camp.palm nuMber. I am an enfjAy-or that;is prar&rrg workers'congxe Lsrziurrz insrirdrzca j'or my enrptoyces. Below is t7te po cy.and job sit& in,jormrrtian Durance Company Naze: - V� o. .. 'Policy 4'or Self ins Lic'_f q--jJ`,W ? � � � l=Lpiiado'it Date: Yob sit,Addis /(o ' �tiy P,�' �31-r' _ ciyrstatt ram: 1 Attach a copy of the work-ere coaupensatiortpolicy ded'aration page'(sho'�uig the policy mr laer'and�rpi ation date). Failure to secure coverage as required-under Se on:25A of MGrL c. 152 can lead to the imposition of criminal penalg s of a ffile up to'su-M ado andfar one-y-earimpriso"nin t as well as civil penalties.ia thf fa=of a STOP WGRk ORDER and a fine- of up to$250-00 a day against.the violator- Be adsased that a copy of this statement:maybe faded to the Office of Iermstigadom o€the DPA for imuu ce co-mrageTiredfication- Ido hereby nuEfit rtnder thg prunes azzd psrtatties a.�fFarj�i�}'chat the iRjbrwa6mj-prm &d abmw is bzrs and carrectL ' itmatur Bate_ xk, Phi 3 Offal use only. Da not o-rrke in tU5 area,trr be campleted'by d y a!rtown v�frcrrzt City or T•onu; PerautUcease;g Lauing nihority(circle one): L Board of Health 2.Ru#Tc&ag Department 3.Cityltasfa Clerk 4.Electrical Inspector S.Plumbing fnspecter 6.Oth-er Contact Person: Fh-azze#: � Massachusetts Departrngnt of Pub0c Safety ►1` Board of Building Requfa Gons and Standards ConstructronSupervisor I_icense:"CS-079883 ` '" Ftestrictedto . Gonstrtrctitr St �isor Pe Unrestnctetl=•Buildings of any use group which contain �s less.than;35;060'eubiC:feet(SS;'t=cubic meters otenctosetl spate. ,54 AN, 4YAY - C.EN.TERVILLE 14 0 rat ion ' Corr$rais'sicsne r 08;2712t117 Failure to possess a"c rren't`e'ditiori ot• be Massachusetts:: $tate;'t3uilding;:Cddii is'caiise for revocation of This license. Di+5 Lieenstfig`anformataon visit'. WWW WASS,�OVJCFS� " � N f E t tcc Of to (fairs and B- slness 1Zcgz It ti Ta 10 Park Plaza - Sulte` 17U: Bc�stc�n ?VlasSacI 't-t 0Z 1_l., Hone.' x� ro:vemer t G61, for Rep n Registration.`. 141 N �. :.. type:" Private,Cdrtroration �Xpiratiom kQ/, A:1;& Tr* .233497" BARSNESS &C0q, INC: ERIC BiARSNESS :.. w v 5 �P,it1GU5 �'-AY` CENTERVILLE, MF� ©2632 -.: _ _.�M.�:.. _.:.:. _...... .... .. .„ . T, - f,pd:atcAdtlress;:and return card;:XvInrk reason for chringe,:, t r1d[lrms „ Reni ei wai i :i�mptoyment Lost Czzrd: ()tiicc oCGonumrr.lffa:ry+ Bnsms�licgul�uon 1 ii ensc;or registration valid for irtdividul:iise naili Zk �itidf'tE:IMPRt3UEMEN'T CONTRACTOk2 before the expiration date If fOhrld c eiurii ta. 'Fierstratibn: Tyree::: , Officeof Consumer 4fTeir,', nd tMincs5 f�e�utatitin. g 14 070: 'Expiration €i6 24t - F,rate,Ccr,,orahon 10 Park plaza=Suite 5170, u .Boston,,,.M 02I�G, , E.A BnRSNES;S fr vQ _NT�ERVILLI-Nl 62a 2�' t nricrserret7rt. ' tiot•v.>lad�t;tliaut si airCure��' Town of Barnstable �+ Re to Services WAM � rY E �+ Birhard V.SC4I}umctor t ti� Bwldmg WyMon - • `r mrmry,BmZdu I.-Comte 200 Main SEA Hyazxis,MA 02601 WWW towb�rasEabIaasa nos Office: 508-862-4038 Fac 508-790-6230 Property Owner Must ' Complete and Sign This Section If Using A Builder ir1G lam'1i1C�S ' as Owner of the s-IIb'ect ro P J P AY b�ISya nsize IG►A _&rsnas s 1 , --L^c r tic)act on mpbehA ' in an to woik a:hoi;z bptbis bmIdiug permit appltr tio,n for. , (Address of job) "-Po01 fences anal alarms are the zesponsli 7of the applicant-Pools . are not to.be flied or iAmd before fence is kstalled and all final inspections.are perf=Md and accepted, S;= Of Owner S =of Q-z T� - -.8ric, A. Pri=Name u QiUxnS-C Dorn ' I Town of Bar table Regdatory Services of Rid-rd V.Scafi,Director $uaTd�mg bividon. t t Tom P=T Bmm mg commm=ner 200 Ifik ft=4 Hpmnis,MA 0260I W4PS4.f[TS'PII b2rM 2bI rrta_M3 Officc: 508-962-4038 F� 508-790-5230 Hon�owt,��ar+�Yrss�rtox DAM L�c m8 rnCar UR- '�OQ71.gR"' a•�a - h®eph®e#• spo�cpl�c� . CaggglT i,�A UM ADDRESS: _ c$p/[a�ea a aP code The euaeat ex� n for`�omeaWneas�'was tendedto kelp&owner-flccpPied dweIImPs of sn:units Cr less cad is Zow hnhneowaas to engage m iad v7&al for hirewho does notpossess a hcemsq goyided t zt&D owner ads as supra-yiSaz • DBP'IId1TIDN ORH0�2RAWIZER .P=an(s)who owns a par=l of land on which.Wsha resides ar iufrmds to resi,dq on w3iirii thew is,Cris fi t mded to ba,a one ar two- famhay dwer t�atiacb6d or deiahed s(rnctn=accessary to snrh use,and/or fa=s*uctorca. A pesos who consft c[a ulaa toe amo submitto tie Official an a firm Tiomamatwo-ycarpc�odshallaatbecansidaed�.bamao�r.� Such`�mr�.ovead'.shaII BmldiBg t�hmldm shall onsblc f=allBachwmic zmdea$m a ectimh tabIz ire thz Bua'Idmg t]'ftchaT, • � p�g bm'Idma v (S ecceP - ThG um dmxigncd`.`bOn=w=e amm cs respa ashIffif y far eompliamm w&tho Stan Bu llffmg Cads and other appIicablo codes, bylaws.rules md.rm htl m - 'Ibe gad`�inmmwne�' tlmtbrlsbe ids the.Tows ofBmnsbblo Bm7dmg Depara cnt m=mspedim pmce�s=A=q h==Xds mdf3ebdsbe wm cnatply wi$i sa a pmcedmrs andrmTxkmn� ' Siva c�Hnmw�n� - • mfBt.0 crmgOfficiRl • Note- Thr=-fam>TydwcMngsmg35,000cubicfeetdr1a:g=wMberegakedtocomplywith.tbaSbdmBtu7dmgCod$ Secdm f27.0 CamtrnL $DIMWNES,'S Sffi8IIDI1 The Code strips i3iat 'Any halimwner performing work for which a b ug pemnit is required shaR be RYA m pt from the provisions of taus secfinn(Section 109.1-.1-Licensing of construction.Smpervisors);provided that if ffie humcumpr engages a person(s)for bile to do such work,that such Homeowner shall act as snpe>vbw r Many homeawners who use this er empfina are tmawar a that they are assmm g t$e responsZilli im of m supervisor C=Appendtz Q,RjTw&RMnbfm rs for Licensing rmwftmcfmn S*crvisors,Section 215) This lark of awareness oftmm results is serious problems,parficmUrlpwhen the hnmwwner hires unlimnSed persons In Ofm czse,onr Board—not pro=c;d agaiust the unlicensed person:as it waurld wiffi a fiaeased Saperdmr- 'Me homeowarr acting ns Supervisor is ultimately responsiblm eon as art of tee To etrs-�e t th a homcawarr is firIIp aware of hislf cr responm5 f des,many require p permit apPHcztj°m6 izat the homeowner certify thathelshe mmAmrsbmds tie respor --bil dim of s Supervisor. On tle bmtpage of this issue is a form earren$y m-ed by several towns- You map caret amend and atopt sack a formlerstifimfion for tme is your cammmxitp R v&ed 06U 13 • I , , — r" I F I I f I I i I I R I I I I I I ^ I I I - � r ^ I , I F I I I i � ;• I i I is ; c; i .� I *i6 I7 , � , I 17 , I _. W ry AD G �+p N O I I I I I i I i , I : : I , I 5 U . i , - I - I I • I j i i I I, � I 1. i i I I I i -- 7 - -----.. - -- ----. I - -- - - -'-- 6-l� -- s -10 I I I I j I i ., _. I { I , f I 1 1 i 1111 I .. I 1 , • : I I I I __.�_-:.�.__. _ : : : - , , I I I I I � , I At I_ I � � : I • D I iz L'.,/6Q : I i 1 �lpnlrr•nEti� ��' , I � �I, I I _ _��I I---' �� {- I I : I I I : boa : : _—�- --L•-- - --- I — i---} -- -- , ---� --1— t -"i-------- �— --t-: t_ _f �.. '��`� �—1 j i '$��p.�„��'.by � , i —�`�±� I I . .-.-- -- -1= '---�- - -_�I _._ - I I -- 10 dl _ I r•� � I : I , : Y ; i NN PROPOSED STONE AREA TO MATCH - Pro C EXISTING FOR BACKUP SPACE --\_ - �+ a N 88°31,02•E 229.96 ------- d y Qwr Her &hJ�S.{Ar�i m -- "/ EXISTING N ..� - - BUILDING Q m EDGE OF EXISTING GRAVEL — b — (PROPOSED m - -. . i MULTI-FAMILY USE DRIVE<PARKING AREA < 'STONE PARKING_ -- .: SPACE - - — I PROP. F )TOTAL BDRMS (3)UNITS � - .EXISTING WATER UNE_ �,_ O (5 T ) N In N s p .. ADO. �yR 5 88°31'02.W — _ _ i (�^ O 14 1.22' 1 SEWER �� f r`EX15TING 5EWER LINO Y , MAIN — W -- ----- z I (4) 1 0' I ll_I STONE PARKING '•` „ ^ SPACES � 1 •;I,} '/ �• (n LOT I 25,G . � N W LLJ o m LOT 2 q Z 13044.3 5.F. Z , \ 52.85' 5 ^ 588°15'30'W 226.85' 51TE PLAN OF LAND FOR 9G WINTER STREET HYANNI5, MA PREPARED FOR ERIC BAK5NE55 I2-23"2015 TMW • - it)Er,NI,nZCi•: 1.5_020 WELLER 4- A550CIATE5 ZONING D15TPICT L: OM(OFFICE/MULTI-FAMILY RE51DENTIA DISTRICT - 1.0-BOX 417 CENTERVILLE.MA 02G32 MINIMUM LOT AREA: 20000 5.F. - - TELEPHONE:(505)328-4G92 MINIMUM FRONTAGE:50" EMAIL: cr�ewener@gmalLcom MINIMUM FONT YARD SETBACK: 20'- REGISTERED LAND SURV EYOK5 t ENVIRONMENTAL CONSULTANTS MINIMUM SIDE 4 REAR YARD 5ETBACK: 10' ! MAXIMUM LOT COVERAGE.80% - �tNVE rqw Town of Barnstable M BAMSTABLE, ' BARNSTABI,E Q� Regulatory Services 9V��D 39'A�� n�ansaxianis os"rtan`�iie r�irsr"e�amTne� , LY•LPJ� _ Richard V. Scali,Director - 16339`--2000L, R, Building Division r Thomas Perry, CBO , Building Commissioner' = 200 Main Street, Hyannis, MA 02601= www.town.barnstable.ma.us Office:508-862-4038 Fax: 508=790-6230 s January p12, 2016 Mr. Eric Barsness 54 Angus Way 4 , Centerville, MA 02632' r RE: Site Plan Review 035-15 Barsness—Multifamily-Conversion 06Wmter St eet Hyannis, Map 309, Parcel 185 Proposal: Extend garage footprint(approximately 170 s.f.) staying within existing building setbacks. Add 2 studio apartments(approximately 210 s.f. each). End result will be a structure containing one 3 bedroom unit and two studio apartments. M Dear Mr: Barsness: Please be advised.that the above proposal has received'an administrative approval subject to the following ❖ `Approval is based upon, and must be substantially constructed in accordance with plan entitled "Site Plan of Land for 96 Winter Street, Hyannis",, prepared for Eric Barsness by Weller& Associates, Centerville, MA, dated 12/23/15. Also, floor plan sketches depicting new apartment layout, smoke detector plan. ❖ Applicant must obtain all other applicable permits, licenses and approvals required, including but not limited to, Health Department and Fire Department approvals at the building permit stage. Upon completion of all work, a,registered engineer or land surveyor shall submit a letter of certification,made upon knowledge and belief in accordance with professional standards that all work has been done in compliance with the approved site plan(Zoning Section 240-105 (G). This document shall be submitted prior to the issuance of the final certificate of occupancy. A copy of the approved site plan will be retained on file. Sincerely, r Ellen M. Swiniarski Site Plan/Regulatory Review Coordinator CC: Tom Perry, Building Commissioner Hyannis FD Health Department II r 111E}� Town of Barnstable r a MU"'ST"B`E, ` BARNSTABLE MASS. Regulatory Services 1639. azxsua 6• rtlnvrui.coNmnrumrs ArlD�`p wanaxs MI15M51614N;<.UF . CC ` Richard V. Scali,Director 169 201J - Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 January 14; 2016 ' Robies Heating& Cooling �j c/o Mr. Edward L. Pesce, P.E., LEED AP ,(1 Pesce Engineering &Associates, Inc. 451 Raymond Road Plymouth, MA 02360 RE: Site Plan Review 002-16 Robies Heating &Cooling 279'Ya mouth Road,.Hyanriis J Map 328, Parcel 139 Proposal: Project involves the n p � e construction of a new loading dock to allow access to the lower basement level at the approximate existing street grade elevation(197.8 ft. —assumed bench mark). This new loading dock will be built in the location of the existing concrete ramp between the existing retaining walls (NOTE: the proposed construction will not further encroach upon the existing sideline setback). The remaining concrete apron will be removed, filled in and brought up to the existing grade, and paved to match the existing parking lot area. Dear Mr. Pesce: t Please be advised that the above proposal has received an administrative approval subject to the following: Approval is based upon, and must be substantially constructed in accordance with plans entitled: ".`Proposed Loading Dock Improvements at 279 Yarmouth Road, Hyannis, MA"prepared for John Robichaud by Pesce Engineering &Associates, Inc., Plymouth, MA dated December 29, 201.5. :• Applicant must obtain all other applicable permits, licenses and approvals required. Upon completion of all work, a registered engineer or land surveyor shall submit a letter of certification, made upon knowledge and belief in accordance with professional standards that all work has been done in substantial compliance with the approved site plan (Zoning Section 240-105 (G). This document shall be submitted prior to the issuance of the final certificate of occupancy. A copy of the approved site plan will be retained on file. Sincerely, Ellen M. Swiniarski Site Plan Review Coordinator. CC: Tom Perry, Building Commissioner C ; = INSULAI� I N1 9' f Cl . " IISS0.OlP55 S[AMLISS SV0.4T IOAM j Pam - q .` .:W..:.�.....� „ a BATS! OUfil Yf IHSUIPSI Tex �L �61Y)�� 1-800-696`6� " Town of Barnstable F " Regulatory Services Building Division 200 Main St Hyannis, MA 02601 - Date: (p 3o/9o/s' " Dear Building Inspector f Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and we atherizat' ion w• work at the property listed ted I 1 Y below. Cape Cod Insulation did this in accordance to the specifications listed on'the building permitp application. All work has been inspected by a certified Building Performance I11st1tUte '(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements, Property Owner Property Address Village �Y Insulation Installed:' Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( ) ( ) ( ) ( ) Slopes Floors Walls ivy r�y GvOr rorf1r%l Sincerely 2Hry E ssrati�on, sident Insc. V o TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map -3� . Parcel' v� Application # k� Health Division Date Issued (�� Conservation Division Application Fee . Planning Dept. Permit Fee 00 Date Definitive Plan Approved by Planning.Board Historic - OKH _ Preservation/ Hyannis Project Street�ddress Village Owner --b e7 Address Telephone Permit Request l Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation vU • Construction Type ��rnvlr Lot Size Grandfathered: ❑Yes ❑ 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) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total !doom Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: 0", isting O hew ize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: I Zoning Board of Appeals Au orization ❑ Appeal # Recorded ❑ Commercial ❑Yes o If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �Jl Telephone Number 154 " j 7 Address Glt� License # i U Home Improvement Contractor# �� b Email Worker's Compensation # W C L 06111---27 G D ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJE T WGLL BE TAKEN TO � Cl. SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE s ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. .t - ; . Tow n of Barnstable ReguiatoryServices v asr Richard p 1 chard V.Scali,Dirtaur ` 13uilin� pig isiu� Perry,l3uitding L ommissiuncr 200 Main Siect,lzp arms,,%•LA 02601 ' . - •w•rvw:.tntivn.barnstabie:ma.us. On-ICC.: 50a-R62-•1.0 S. 1 508 ..9G-b2:0 . 1'ropetty C7rc-tiez 'C omp cae and sip '.I"his ScrLic:>n ' if 1Jsin� A Rt4der Jailr cd t ;act Or r.lh&eh rzij�n AA t CAPeL. �aif, L t1 !TL3ET C1 i:°,''iI'r'[ to Cl7:k i4OrIzt._ 1IIlS'CJt � 1:1y E}a a7 .. {Mditss of job) Pool :�r_ccs and• �� the��.S�ticl,a5i�i�lt� c�i the i ��1u � t 1'cltak :are 110t.to bi: �l t:d ��rtat iLrcl lac ore !;Alec is lrLtaRzc ."tLJ � au 1.1.spcctpis are pelf<,amud,ar_d .xcczmwd Oz Print`Tai ne. .. (� — ._ A�IZL�l�du ; ' Q•r�IFJ'9C�)1:�FR_ a,r155ti��;•{XLi Massachusetts I.- Department-of Public Safoty Bo'ard of Building Regulations and Standards Construction Seipervis6l, License: CS-100988., HENRY E CASSPIV 8 SHED ROW WEST YARMOUTH �,•�... �1 " �`� Expiration Commissioner 11/11/2015 a' Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston, Massachusetts 02116 Home Improvement Co'nt.ractor Registration Registration: 153567 Type; Private Corporation " Expiration: 12/15/2016 Tr-9 259188 CAPE COD INSULATION, INC HENRY CASSIDY - 18 REARDON CIRCLE - SO. YARMOUTH, MA 02664 ','Update Address and return card, Mark reason for change. CAI {i 2OM•o5/it Address Renewal Employment Lost Card die�aro��zarzcuea�C✓(11 04K'jdceOX,uae0 5—�\ Office of Consumer Affairs& Business Regulation License or.registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistratlon: '1,53567 Type: Office of Consumer Affairs and Business Regulation Regulation. Private Corporation 10 Park Plaza -Suite 5170 ;,. Boston,MA 02116 -APE COD INSULAti.,' N;'INC'.z`i`r'..` iENRY CASSIDY j 18 REARDON CIRCLE 30, YARMOUTH. MA 02664 Undersecretar Y N valid wi tit sign •e M - The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations a 1 Congress Street, Suite 100 >` Boston, MA 02114-2017 www,mass,gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Or 'zation/Individual): Address; 60 � V — G City/State/Zip; At U�M f� (0 Phone Are you an employer? Check he appropriate box: Type of project (required); 1.5 I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time),* have hired the sub-contractors 6, ❑ New construction j 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7, 0 Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity, employees and have workers' [No workers' comp, insurance comp, insurance,l 9, ❑ Building addition required,] 5, ❑ We are a corporation and its 10,❑ Electrical repab-s or additions 3,❑ I am a homeowner doing all work officers have exercised their l l.❑ Plumbing repairs or additions myself, [No workers' comp, right of exemption per MGL l2.❑.Roof repairs insurance required.] t c. 152, §1(4), and we have no i employees, [No workers' 13,[ Other comp, insurance required,] // +Any applicant that checks boxl must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit thisvff davit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees, If the sub-contractors have employees,they must provide their workers'comp,policy number. 1 am an employer that Is providing workers' compensation Insurance for my employees, Below is the policy and)ob site Information, Insurance Company Name; 1' CiQVJ.46V �� ((�(�(✓� Policy# or Self-ins, Lic, #; GIYU102 1 �� Expu•ation Date: , U f�� Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration'page (showing the policy nut ib r and expiration date). Failure to secure coverage as required under Section 25A of MGL c, 152 can lead to the impositio of cri.muial penalties of a fine up to$1,500,00 and/or one-year imprisonment, as well as civil penaltiesvi 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. 1 do hereby cert�o n r pains and penalties of per)ury that the lnformatlon provide I abov is true and correct. Si nature: Date: ") Phone#: Officlal use only, Do not write in this area, to be completed by city or town official, �l - City or Town: Permit/License # Issuing Authority(circle one): 1. Board of Health 2, Building Department 3. City/Town Clerk 4. Electrical Inspector 6, Other 5. Plumbing Inspector Contact Person: Phone#: �J From:Rogers&Gray InsuraFax: To:+15087786735 Fax: +15087785735 Page 2 of 2 0113012015 10:04 AM CAPECOD-27 BDELAWRENCE AC_ORO CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY' 31301230/2015 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, EXTEND 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(ies)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 - NAME: Rogers&Gray Insurance.Agency,Inc. PHONE FAX 434 Rte 134 Arc No Ext: A/c No): (877)816-2156 South Dennis, MA 02660 E-MAIL 1 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURER B:SAFETY INSURANCE COMPANY 39454 Cape Cod Insulation,Inc. INSURER C:Endurance American Specialty Ins. Co. 18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth, MA 02664 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 CONTRACT OR 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 ADDL SUBIR PO CY FF PO[CY EXP — LTR TYPE OF INSURANCE INM WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX]OCCUR CBP8263063 04/01/2015 04/01/2016 PDAMAGE IQREMISES Ea NCIEDnceUIT0 $ 100,Q-1 MED EXP(Any one person) $ 0 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- ---�� JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,00Q OTHER: $ --�AUTOMOBILE LIABILITY OMBINEeDISINGLELIMIT $ 1,000,000 B ANY AUTO - TBD 04/01/2015 04/01/2016 BODILY INJURY(Perperson) ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Peracciclent) $ X HIREDAUTOS X NON-OWNED PROPERTYDAMAGE AUTOS Peracciclent X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 C EXCESS LIAR CLAIMS-MADE EXCIOOO6635000 04/01/2015 04/01/2016 AGGREGATE $ DED I X I RETENTION$ 10,000 Aggregate $ 2,000.000� WORKERS COMPENSATION -- --{ AND EMPLOYERS'LIABILITY Y/N STATUTE OERH !I D ANY PROPRIETOR/PARTNER/EXECUTIVE WCE00431900 06/30/2014 06/30/2015 E.L.EACH ACCIDENT 1,000,0OFFICER/MEMBER EXCLUDED? fry INIA 00 (Mandatory )( ry lb NH E.L.DISEASE-EA EMPLOYEE $ ,1,000,000 If yes,describe antler DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00OI DESCRIPTION OF OPERATIONS f LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided underthg General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE VUTH THE POLICY PROVISIONS. South Yarmouth, MA 02664 ' AUTHORIZED REPRESENTATIVE ©1988-2014'ACORD CORPORATION. All rights reservecl. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 7 Are IpAi Prvpr�Scot � CAHJ, edrV67MMASSq�s U H BEINSS)q L �x U'tor SE7BUICDIN�C ODE c c.CS` A S (� S RENIEWE SMOKE DETECTOR BAR TABLE BUILDING DEPT. D FIRE DEPARTMENT DATE:-- ; BOTH SIGNATURES ARE REQUIRED FOR PERPA/TTII, h' �-- -� -IQ -41 QP Poc .. �7 - , IOPERTY ADDRESS I ZONING (DISTRICT CODE SP-DIST& DATE PRINTED(CSTATE LASS( PCS I NBHD KEY NO. 0096 WINTER ET 07 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT(ACTORS TY UNIT ADJ'D.UNIT L ano By/Dale Co. size Dimenson ACRES/UNITS VALUE D—i, MAHER o- F R AN C E S V` M A P— LOC./YR.SPEC.CLASS ADJ. COND. P E PRICE PRICE #LAND, • 1 " 46 900 CARDS IN ACCOUNT - FF�De IhiAcres 10 1BLDG.SIT 1 X .30 =10 217 71999.9 156239.9 .30 46900 #BLDG(S)-CARD-1 1 68.700 01 .OF 01 #OTHER .FEATURE 1 IP200 COST 116BUO BATHS 3.0 U X C= 100 10500.0 10500.0 1.00 10500 B #PL 92 WINTER STREET HT MARKET A iRoETGAR S 14 X 22 193 C= 100 220 19.3 3.87 7. 5 308 1200 F 480 3300-3 #RR 1866 0103 IUSEOME D APPRAISED VALUE JI A 116s800 U ! PARCEL SUMMARY i i S LAND 46900 I BLDGS 68700 M 0-IMPS 1200 EI TOTAL 116800 N CNST N ! T j DEED REFERENCE i s� DATE S iee d� PRIOR YEAR VALUE Book Page MO. Y,.D LAND 46900 S 1349/572 00100 BLDGS 69900 TOTAL 116800 BUILDING PERMIT *HOUSE ADJ.. OBS Nombar Dale Type Anq°n1 COND. GIVEN D U E LAND LAND-ADJ INC ME SE SP-BLDS FEATURES BLD-ADJS UNITS TO APT. LAYOUT. 4690D 1200 6700 *THE 1ST FL APT. C is ss C°nst- Tola' Base Rale Atl.Rate Y�eAa�Ir B°ill q Norm. Obsv. _ IS RESTRICTED IN U oils Unils I A -D I 9e Depr. Contl. CND. Loc. 4b R.G. Re pl.Cost New AOI.RePI.V°lue Stones Heigh( Rooms Rms.Belhs ♦fix. Pe�tywell FK. USE WITHOUT SOME 03 000 100 100 65.15 65.15 30 70 24 74 95 100 70.3 97745 63700 1.3 7 3 3.0 12.0 MINOR CONST... Rate Square Feet RepL Cosl MKT.INDEX: 1.00 IMP.BY/DATE: ML 2/91 SCALE: 1/0 0.5 6 ELEMENTS CODE CONSTRUCTION DETAIL *L N D A D J F O R U S E 1100 65.15 480 31272 GROSS AREA 0NTH=RE=E fAM`ILY. DWELLING CNST GP:00 FSF 90 58.64 742 43511 *-----21----* STYLE HOLD STYLE 0.0 318 52 33.88 480 16262 ! FSF 8 DESIGN ADJM_T_ _00 ____0. ! *6-*. EXYER.WA_LLS 11 woo D SHI_NGLES0._ i8 ! HEAT7AC TYPE 090IL-HOT WATER �. INTER.fIP1ISH _05PLASTE_R _ 0� ! ! INTER.LAYOUT T3BELOH AVERA6E CF. *-8-* 26 ,E INTER.DUALTr 025AME AS EXTER._ 6. l FLOOR STRUCT 02MID 10I5T78EAM 0. D W 16 ! EFLOOR COVER �OtARPET $ PINE 0. E TglalA,eas A° = Base= 1222 ! ! ROOF TYPE- -- -01 GA9LE-;SPH -SA----O. _________ T UILDIN DIMENSIONS . ! E L E C T R I C A L OO CV. A SAS 130 N16 E10 FSF N16 W08 N1$ *-1D-*----19----* FOUNDATION 048RI C _ __K VALLS 94. 1 E21 SOB E06 S26 W19 FSF .. SAS ! ! -"----------- --- E20 S16 .. B18 W30 N16 E30 S16 16 BASE 16 COM9IERCIAL NB NU IN HYANNIS NY1S L ! ! LAND TOTAL MARKET 818 ! PARCEL 46900 116800 *-------30------X AREA VARIANCE +0 +0 STANDARD 50 } [PAR] [R309 . 109 . LOC] 0096 WINTER STREET CTY] 07 TDS] 400 KEY] 224563 4 ----MAILING ADDRESS------- PCA] 1051 PCS] 00 YR] 00 PARENT] 0 MAHER, FRANCES V MAP] AREA] HY15 JV] MTG] 0000 92 WINTER ST SPl] SP21 SP31 UT11 UT21 . 30 SQ FT] 1702 HYANNIS MA 02601 AYB] 1830 EYB11970 OBS] 95 CONST] 0000 LAND 46900 IMP 68700 OTHER 1200 ----LEGAL DESCRIPTION---- TRUE MKT 116800 REA CLASSIFIED #LAND 1 46, 900 ASD LND 46900 ASD IMP 68700 ASD OTH 1200 #BLDG (S) —CARD-1 1 68, 700 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 1, 200 TAX EXEMPT #PL 92 WINTER STREET HY RESIDENT'L 116800 116800 116800 #RR 1866 0103 OPEN SPACE COMMERCIAL INDUSTRIAL y fi EXEMPTIONS SALE] 00/00 PRICE] ORB] 1349/572 AFD] LAST ACTIVITY102/18/93 PCR] Y 1 �c l 'f Sir y R309 109 . �P P R A I S A L D A T KEY 223831 GORE, RICHARD D LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 30, 600 17, 700 268, 000 2 A—COST 316, 300 B—MKT 252, 700 BY 00/ BY ME 12/87 C—INCOME PCA=1111 PCS=00 SIZE= 2724 JUST—VAL 316, 300 LEV=400 CONST—C 0 ----COMPARISON TO CONTROL AREA 63BC -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 63BC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND—TYPE 306001 LAND—MEAN +O' 3163001 61720 IMPROVED—MEAN +3340 200 ] FRONT—FT ] 100 DEPTH/ACRES TABLE 02 1000] LOCATION—ADJ APPLY—VAL—STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR]AREA—MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION— [ ] STRUCTURE—CARD NO— [0 0 0] DATA— [ ] XMT [?] 'a �4S r R309 109 . P E R M I T [PMT] ACTIORI CARD [000] KEY 223831 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT } =a a� �f TOWN OF BARNSTABLE 8F3POx" LEMENTARY/CONTINUATI REPORT NAME (LAST, FIRST, MIDDLE) DIVISION /Darr NOTE DETAILS i OBSERVATIONS-ITEMIZE EVIDENCE, SERIAL SS ETC. lVej I SUBMITTED BY /}., PAGE S r r' OF THE The Town of Barnstable * &AMSrABLFs 9� MAS& 10� Department of Health, Safety and Environmental Services '°TEc�na't°i Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner May 30, 2000 ALICE C. MAHER 47 REBECCA LANE OSTERVILLE, MA 02655 Re: Certificate of Inspection Multi-family Dwelling (5-year Certificate) 96 WINTER STREET, HYANNIS 309 185 Dear Property Owner: Attached you will find an application for a Certificate of Inspection as required by Section 106.5 of the Massachusetts State Building Code, Sixth Edition. Please complete the application and return to this office with the required fee: 8 Units - $91.00 The fee has been established by the State (Table 106) and must'be paid before the Certificate of Inspection/Capacity Card may be issued. A copy of said Certificate shall be kept posted as specified in Section 120.5.2 of the State Code. Sincerely, Ralph M. Crossen Building Commissioner RMC/lbn j000424a °F IHE Tp� The Town of Barnstable • iARNSTABLE, • 9cb 1639.MASS, 1e�' Department of Health, Safety and Environmental Services '°rEnna�° Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 , Ralph Crossen Fax: 508-790-6230 Building Commissioner May 15, 2000 AM 1 4 `7 0 � 7 Re: Certificate of Inspection Cam- o�Lss Multi-family Dwelling (5-year Certificate) 96 WINTER STREET 309 185 Dear Property Owner: Attached you will find an application for a Certificate of Inspection as required by Section 106.5 of the Massachusetts State Building Code, Sixth Edition. Please complete the application and return to this office with the required fee: 8 Units - $91.00 The fee has been established by the State (Table 106) and must be paid before the Certificate of Inspection/Capacity Card may be issued. A copy of said Certificate shall be kept posted as specified in Section 120.5.2 of the State Code. Sincerely, Ralph M. Crossen r Building Commissioner RMC/lbn j000424a t TOWN OF BARNSTABLE BUILDING PERMIT,APPLICATION_.,.. Map Parcel,,j Application # Health Division Date Issued 1 Conservation Division "Application F Planning Dept: `Permit Fee: �" — Date Definitive Plan Approved by Planning Board Historic - OKH: Preservation/Hyannis Project Street Address C. Village 4w) h Ift Owner IC,e Address K 4 a S Ile Telephone -Permit Request 0 rew-Ero,0 ; b r e M S bare feet: 1 st floor: existing 9 Pro ose 2nd floor: existing ProPosed� al new , Zoning District (m r Flood Plain Groundwater Overlay Project Valuation C.00 Construction Type od ra►4e.- Lot Size Grandfathered: ❑Yes ❑ No If yes, attach su ' orting-d'ocufibntation. Dwelling Type: Single Family ' Two Family ❑ Multi-Family(# units) Age of Existing Structure D Historic House: ❑Yes ,(No On Old King's Highway: ❑Yes *No Basement Type: El Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Y-69 Basement Unfinished Area (sq.ft) R b Number of Baths: Full: existing new 0 Half: existing new d Number of Bedrooms: existing 1 new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑Other Central Air: ❑Yes ANo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION il (BUILDER OR HOMEOWNER) Name Telephone Number Address A License # Zf8 ay -- 11��°i �� Home Improvement Contractor#CSTl tt V Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Yrm� SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# _ DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER k DATE OF INSPECTION: FOUNDATION FRAME INSULATION •- 1 i( FIREPLACE 2 ELECTRICAL: ROUGH FINAL ' k PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' ,* FINAL BUILDING �� J o%`0 T DATE CLOSED OUT ASSOCIATION PLAN NO. { k The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations + a 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information J— Please Print Le ibl Name(Business/Organization/Individual): of A AmcT Address: p. City/State/Zip. r 6 Phone.#: ��'/ —��3,� Are ou an employer? Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I Xemployees(full and/or part-time). * have hired the sub-contractors 6. ❑New construction .2.❑ I am a sole proprietor or'parhier-' 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' 9. ❑Building addition - [No workers'comp.insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its '10.0 Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. " t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractoms 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 subcontractors 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: t • r Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: `d _ Attach a copy of the workers'compensation policy declaration page(showing the policy nurlber and expiration date). Failure to secure coverage.as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fie tip 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 certi under the pains and penalties of perjury that the information provided above is true and correct Si afore: Date: _. Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board.of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their.employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." r An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete-and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the'event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in _(city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license of permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: Site Address: print Town: Applicant Phone: Applicant Signature: Date of Application: NEW CONSTRUCTION: choose ONE of the following two options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab Option 1: Basement P Fenestration exposed Wall Floor Perimeter U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER R-Value R-Value and Depth National Appliance Energy .35 R-3 8 R-19 R4 9 R-10 R-10, Conservation Act(NAECA)of 4 ft. 1987 as amended,minimums or eater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed (780 CMR 6107.3.2) REScheck—Web which can be accessed at http://www.energ cy odes.gov/rescheek/ ADDITIONS OR ALTERATIONS,TO EXISTING BUILDINGS OVER.5 YEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b_ a) SF 100 x - _ % of glazing (b) Glazing area equals SF b a .If glazing is<'40%.use the chart below. If glazing is> 40% proceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Fenestration Ceiling and .Wall Floor Basement Wall Slab Perimeter U-factor Exposed floors R-Value R-value R.-Value R-Value R-Value and Depth .39 R-37 a R-13 R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e.not compressed over exterior walls, and including any access openings). SUNROOM—An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information.Form (found in Appendix 120.P) .,ws, Town of Barnstable Regulatory Services BARKST.,,M : Thomas F.Geiler,Director NUM i63;9� .0� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 026.01__ www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: NO JOB LOCATION: number InK street O t- 2•l�lage,e �ry "HOMEOWNER": /L t- C (/IQ.fS S S0- O -7,? _-4o 1 j J0- , "9c� b 4Vk name home phone 1# work phone# CURRENT MAILING ADDRESS:! GGS . WGr/t/ tyoVM 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. DEFINTnON 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 se6tion(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 A Duid 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:homcexempt - i o� T�ti Town of Barnstable ' Regulatory Services KAMLerg, Thomas F.Geiler,Director 16.1g�EDN16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property'Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION gfjt<hft,4 CARBON MONOXIDE ALARMS \ (y MUST BE INSTALLED PER p e MASSACHUSE17S BUILDING CODE G,or, cce.S I SMOKE DETECTORS REVIEWED St5 u- �- p BARNSTABLE BUILDING DEPT DATE FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING �a s - rooyvi t 12ad r►1, = —� Cam' S�r 4 t. (h CMUSomMONOXIDEACA ropasCd MASSACHUSEITSBUIC�PERODE , �x U7 or SMOKE DETECTORS REVIEWED BARNSTABLE.BUiLDING.DEPT. c DATE FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING lldc,ir 4 se- --- ,�s - - �4 .. � � � _ - _ .. �� + ... - _ �, ,. _ O O � '� L � �, Q' � . V � ._ �., `J ,U� �. �� - .. r.-� :�.� - :. Y i - �` , � I "� . -. : F THE l°� The Town of Barnstable snMsrABLFe ' �m� Department of Health, Safety and Environmental Services 'OrEn 39. 6. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner May 15, 2000 FRANCES MAHER 96 WINTER STREET HYANNIS, MA 02601 Re: Certificate of Inspection Multi-family Dwelling (5-year Certificate) 96 WINTER STREET 309 185 Dear Property Owner: Attached you will find an application for a Certificate of Inspection as required by Section 106.5 of the Massachusetts State Building Code, Sixth Edition. Please complete the application and return to this office with the required fee: 8 Units - $91.00 The fee has been established by the State (Table 106) and must be paid before the Certificate of Inspection/Capacity Card may be issued.. A copy of said Certificate shall be kept posted as specified in Section 120.5.2 of the State Code. Sincerely, Ralph M. Crossen Building Commissioner RMC/lbn j000424a I • I I t 1 I I I I i i �„~ i � � � 1 I � I i I I i-- i ' I. _ _ - ._ I._ _ ._-i .- i---- -i._...�-I1�„'_i • .. I I I , I- • I - -- --- oo/I` I I I I I f ! ! I -- �- - - - -- - - -- - - I I '' r - - - I i I I i I ' -1 1 I I -_ I I � --.. ---- —�r - - — I IZO a I , I i ' I , I i i • I . , , - _ _ If I I -- ; I . I I i I 7: I i , I J i I i I I i I I I i I 1 I I I : I , 1 ' I I I I I 1 I � + i I , I i 1 , J J I i i - i i ---_ __ _ _ _ ► .I , J _ I i - ' I ; . I , - I • I a7 . - �: ,.,. :A w ^a , . �_ _ ,._ K _ . . . _a._ ,-._ - Y _ L. _ .. d _ u_.. ,. 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