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HomeMy WebLinkAbout0263 WINTER STREET a � � . f - - - -- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I Parcel 6 �" Permit# 700#0 Health Division Date Issued Conservation Division Fee Tax Collector Treasurer �i� Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address G W i Y0,V°ex 5+(' Village ► A ww z S Owner%Y)r -1-m rS B 0 h► ry w 1.l� Address �°v� ter' 5'telephone -7'7)^ ©9 9 9 Permit Request—1© r i►o / S�f-- ��� �A r►q�P_ ©11� V Square feet: 1 st floor: existing ?00 proposed 2nd floor: existing 7, 0 proposed Total new Estimated Project Cos; poQ Zoning District Flood Plain Groundwater Overlay Construction Type wed Cy,�\A)nje, Lot Size S Do0 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 70 y Historic House: ❑Yes 0Q No On Old King's Highway: ❑Yes 50 No Basement Type: 0 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) "T Basement Unfinished Area(sq.ft) 7 5-D Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count 14 Heat Type and Fuel: ❑Gas 04 Oil ❑ Electric ❑Other Central Air: ❑Yes $ No Fireplaces: Existing 0 New Existing wood/coal stove: ❑Yes 4 No Detached garage:(A existing ❑new size 9q 0 Pool: ❑existing ❑new size Barn:❑existing ❑new size • Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: ZoningBoard f Appeals i o ppea s Authorization ❑ Appeal# Recorded❑ Commercial Cl Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name '���c� m, CovV r%4Q Telephone Number 771 -'29 7 Q Address 1D hoc v I- Sf. License# C a /- yn w`'vc 5 ma. Home Improvement Contractor# Worker's Compensation# . /Yl P I l7c 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO VJ?CM0 c?+t't l,l9yu rp F;'1,L SIGNATURE i DATE 12 — In ® 9 of FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED d 4 MAP/PARCEL NO. -' ADDRESS - VILLAGE - ` OWNER ^}y DATE OF INSPECTION: FOUNDATION < ' ' FRAME -INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL _y GAS: ROUGH FINAL x• FINAL BUILDING. DATE CLOSED OUT ASSOCIATION PLAN NO. f ti I The Commonwealth of Massachuse= —' - Department of Industrial Accidents -- :_ 600 Washington Street -_ Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name locatioyn� O city tiV yNWY,5,'n� r phone 005-09 `7-71—,C99 7 57 ❑ I am a homeowner Performing all work myself am a sole etor and have no one in aav ear 1 workers compensation for my employees working on this job. ::::::::::::::: :•:::.::•{.x{::.::::.,,•::: I am an ��]{�� r'_" ............ . •' ...... .....::.};.�.:Ti:?•y':{:•i:+::•i:•i::ii:ii:?i?•i:?_:-::4}:•:4:•i:i:::vv:w.�:::::::��:�::::.v.:...:•:::•::.:'}:�::' :..:.........,..:.:........................:............. ... .......}...................... v name:: ...F, :::.::?.. :.,:::.::,.:::::..::.::.::,:.;:............ roar an :.::.::::::.,:.,.. ..... - :.:............. ..........:..::......x.......}:•r.v...r{4.........;.::.:•::.:. / :...:i.c.F,w o::.:•:::.,::::::.,..:..•r.� .......{..:,Y•:..........r..}r:•:n:•.... . ..... -...... .. ... .....:. .... :w:.:x`vr..1.x•::::.i{4v+{Yit}.n.i.}....:•.v:x.::::.w::::::::::::v:.:. ?`. n......n....... n:.•.�:v.:v:{{:{•:.v::::vv:•.' ..............::.:r..............................,......,.. ..:.,...: ::...... ,.a.}....,,..:...:..%{:{.:..... ..i.:.,}.wY.a.:.in•r}....::...:..:..::...................::.:..r-... dfr .... .. .:Y..�..... <:'� .............. insurance co. ❑ I contra am a sole proprietor,general ctor,or homeowner(drde one)and have hired the contractors listed below who have thefollowing workers'co enration &= fo gor.....................mP....... -.... ...:.:.::::::::.:..... .. .:..::..::......::.:::::::::.:.:.::::.::.....................:..:.:..:::::::::j:.::.�.::::::::::.�::.::::.�:.::::::.:::::.:}}}:.::4}:.x.::.:i:.:?<.;::<.;>:::�;::. ........ .... ......::::::.:.... ...... .... .... ...:......::.:...............:.::r.:•.:...:::...::::•::::::.:•:•::•::•:...r.a•.. ...;4:•:::::::4:a}}x•}>}}x•}:.}::?.}x.:::•.};.::.::.;.......::4}..::::.}.:::::.;:::::.: . ..... ............... ..... ... ...........................................:... ......... ...... .:...x,: :.........}r.}... ..... ..............::............;w::rev:x:.:w;; 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O��{.�:�F::.......... Fiflon to seeum coverage ea required""der Section 25A of MGL I52 can lead to the imposition of c rtmonal Penalties of a Hue to SI,S00.00 and/or one years'Imprisonment as weR as dvH pendtln in the form of a STOP WORK ORDER and a fine of S10Q00 a day'against me. I understand that a copy of this statement may be forwarded to the OHiee of bmsdgxdom of the DIA for coverage vaiHeation. 1 do hereby c fy under the pains mid p ofpQlurY rho the mforntation provided above is&W.mid coned r Date Si Print name T ` j A EY M C.Q rU tt A i'� Phone# - 771- 7 oindal use only do not write in this area to be completed by city or town official city or town: permitAicense it E3Buffdjng Department ❑ Acenshig Board ❑checkif immediate response is required ❑Selectmen's Mice ❑Health Department contact person: phone 0*1 (tawad 9l95 P)A) 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 cc=--.= 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 recewer c: trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more thaw three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, constzuctim or repair work m 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 renewai 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"'s"*ance requirements of this chapter have been presented to the contracting authority. FNEAM Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying many names,address and Phone members along with a certificate of insumnn e,as all affidavits may be submitted to the Department of Industrial Accidents for omfirzanticm of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be reburied to the city or town that the application for the permit or license is being requested,not the Department of Indust dd Accidents. Should You have nay questions regarding the"law"or if you are required to obtain a workers' c omp6=6oa policy,Please call the Department at the number listed below. City or Towns at the bottom o Please be sure that the affidavit is complete and printed legibly. The Department has provided a space Please f the affidavit for you to fell out in the event the Office of Investigations has to contact you regarding the applicant. be sure to fell in the pe>mitlliceose member which will be used as a reference member. The affidavits may be rctarned i o the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you 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 member. The Commonwealth Of Massachusetts Department of Industrial Accidents amce of Iwesduadons 600 Washington Street • Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat 406, 409 or 375 9�M Department of Health Safety and Environmental Services gas¢ ,m Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 BuiIding'Commissione Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERNIIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: ® Estimated Cost Address of Work: 1AYAvuw.-5 yO A Owner's Name: r�r+rn�s. ROW S14,,v��z-. Date of Application: , 0 — I hereby certify that: Registration is not required for the following reason(s): Work excluded by law [3Job Under$1,000 Building not owner-,occupied COwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME ZWROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERMY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. s OR Date Owner's Name q:fomu:Affidav HOME IMPROVEMENT CONTRACTOR Registration 124074 ME EW Type - DBA o Expiration _ 05/09/01 T - Conrad Remodeling f Jeffrey M. Conrad p���" 0 ocust St ,. ADMINISTRATOR Hyannis MA 02601- E i _ ilk TDamvnza7uaea� al✓vCcwvae�iuretlJ DEPARTMENT OF PUBLIC SAFETY ,+ CONSTRUCT ION`.SUPERVISOR ICENSE N�mGEr ;Plres: Birthdatr: CS _ 984857 12J23J1999 12;23J1SS• - Res To _ JEFFREv..N C1)aRAO P°;YANNis, 'idA. +2501 .{ _ m , y The Town of. Barnstable Department of Health, Safety and Environmental Services •M_ = Building Division 367 Main Street,Hyannis MA 02601 . Office: 509-790-6227 9 Ralph MCrosse»z Fax: 508-790.6230 / Building Commiss;c-. Home Occupation Registration � 12- 10 Hate.. Name. P"o Phone ##: so g _- -I-) Address: Type of Business- L- ��t�✓ ��-}� (,��-�.1�i`� Map/Lot: 3`() ' 2.p � INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings„subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or gmu ndwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which arc not customary in residential butldinrs,and there is no outside evidence of such use. o No traffic will be generated in excess of normal residenual volumes. • The use does not involve the production of ofrenshc noise.%ibration,smoke,dust or other particular matter,odors,electrical disturbance,heat.mare.humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generaued by such tee shall be met on the same lot containing the Customary Home 'Occupation,and not within the required front hard. • These is no exterior storage or display of materials or equipment. • 'There is no commercial vehicles mated to the Customary Home Occupation.other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to e axed 4 tires,parked on the same lot contain*the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Ootarpation. • If the Customary Haase Occupation is listed or advertised as a business,the street address shall not be inducted. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwellin8uniL 1,the undersigned,have read and agree ivith the above restrictions for my home occupation I am registering. Applicant: —_- Date. la -7 Homecc.doc