Loading...
HomeMy WebLinkAbout0269 WINTER STREET (o9 W' 54-, . Application number .....�..... ........ tt�E Qa � Fee ...............#,.:13$ ... g ` ............ J` Building Inspectors Initials..............` .................. ' MAY 07, 2019 �L Date Issued...................... �. .I. ,.:.................... TOWN O� BARNSiABLE � � !� Map/Parcel.....S31.0. C.�S.......... ....................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO W S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION j Address of Project: Q0 9 L0 a n�e-r rN1 NUMBER STREET VILLAGE Owner's Name• -I' , MdikoneNumber.60'% -779 j Email Address--P" 1 0C, CcMell Phone Number��.�'MZJ ®O Project cost$ 4ioo Check one Residential (r Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize_je�C Co cti r'a-A to make application for a building pe accordance with 780 CMR _ Owner Signature: Date: 1-1' 1 , TYPE OF WORK OSiding 0 Windows (no header change)# E-1 Insulation/Weatherization , Doors (no header change)# / Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to 96,*`avy CONTRACTOR'S INFORMATION Contractor's name ,S-; �1 (foW 'NP\ Home Improvement Contractors Registration(if applicable)# 1p9N L� (attach copy) Construction 'Su ervisors License# P ���5 t�7 (attach copy) Email of Contractor CcmH'4 P801o��\, P,,,..,,4",r„&r-Phone numbe6�j `7 3 ALL PROPERTIES THAT HAVE STRUCTURE OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY.IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL'BEFORE A PERMIT CAN BE ISSUED. 3� APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No I , if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type .Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APP ICANT'S SIGNATURE Signature // Date V I All permit plc Lions are subject to a building official's approval prior to issuance. r� a The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name (Business/Organization/Individual): E/'S�'�'H L•AV17d Address: 535 Ytv r-iw�,q City/State/Zip:C�,jk--4'�e\1 iypi G 2r Phone#:� Are you an employer?Check the appropriate box: Type of project(required): L❑ 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 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑_Demolition workingfor me in an capacity. employees and have workers' Y P n'• $ 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13 Other, &0f Q comp.insurance required.] C *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. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractor;and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: -- City/State/Zip . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains an enaldes of perjury that the information provided above is true and correct Si afore: �"► Date: 1` Phone#: —2ga 7 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." 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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(L'LP)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 - F Yt •Y Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference 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 or permit to burn 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 Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia _ r Commoavrea of Massachusetts ..; Divisbn of Professional Licenswe hoard of Sunt"Regu!Wons and Standw0s Constrttc'fori t6pervisor a CS4309867 ires:1212312019 .iIBY N(SAD - 535 t�tltillElf5�1 '_,�' • `t1�31a ' `. commissioner _ =-�1te �c+aHna�titperrl/�i��•xLas3a�[�.i�: . Valid iw ��r HOl/E IISRAOVENENT CdNTRACrOR . i; :R ... date. if ftmd return to -TYPE:* �_ the - �jg nessRegr$adiorr Afisirs tZa`Suibe'5170 �f2 , ' Boston,Nlof Cp�116 DIWA CONRAO tit UL -c FIRM p. _ JEFFOEYK CONS z EYS '� f Not v3hd.ii�ss9 •- - CENTERVILIEa�flP► _ �.K. -- _ : • ,gyp.:s,�a k�,�.:�-F _ t 1 006 6)lfll-�r Town of Barnstable *Permit Expires 6 mont o iss a©O Regulatory Services BARNSTABM Richard V.Scali,Interim Director Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number caw e�D Property Address W Residential Value of Work$ lad Minimum fee 35.00 for work under$6000.00 Owner's Name&Address Contractor's Name &Lj" // Telephone Number`g�� Home Improvement Contractor License#(if applicable) (D O 0 Email: Construction Supervisor's License#(if applicable) 00 9 VV XWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner M.I have Worker's Compensation Insurance Insurance Company Name A446 A2L w Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ] Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑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 Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is equired. SIGNATURE': TAKEVIN_MBuilding Changes\EXPRESS PERMI S.doc Revised 061313 Authorization Form: T - Ic�. as owner of the subject property, hereby authorize Baker & Associates to act on my behalf, in all matters relative to work authorized by this building permit application for Address of property: 269 Winter,Street Hyannis, MA Signature of owner: -71 Print Name: o. .� Date: 'S1 ��S Client#:9742 2BAKERAS ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 04/22/2015 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 PHONE F Insurance Agency I C,NoE>n:508 775-1620 A/C,No): 5087781218 ADDRESS: 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE j NAIC# Hyannis,MA 02601 INSURER A:National Grange Mutual Insuranc INSURED INSURER a:Associated Employers Insurance Baker&Associates,inc. INSURER C: P 0 Box 923 Centerville,MA 02632-0071 msuRERD: INSURER E: INSURER F: I 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. LI RR TYPE OF INSURANCE INSR WVD POLICY NUMBER BR MM/DD/YY MM/DD/YYYY LIMITS A GENERAL LIABILITY MPJ7223M 4/19/2015 04/19/2016 EACH OCCURRENCE--$1 00O 000 DAMAGE 70 RENTED X!COMMERCIAL GENERAL LIABILITY PREMISES E E Erence s500 OOO 1 ;CLAIMS-MADE �i OCCUR MED EXP(Any one person) $1 O 000 I PERSONAL&ADVINJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY JE LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I Ea accident i ANY AUTO BODILY INJURY(Per person) $ ALL OWNED 1 II SCHEDULED t AUTOS I !AUTOS BODILY INJURY(Per accident) $ 1 HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ I $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LUAB HCLAIMS-MADE AGGREGATE $ DIED F I RETENTION$ B WORKERS COMPENSATION WCC50050024542015A 4/23/2015 04/23/201 X I WC STATU- OTH- - AND EMPLOYERS'LIABILITY ANY PROPRIETOWPARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? F N/A E.L.EACH ACCIDENT s500 OOO Mandatory In N If yes,describe under � E.L.DISEASE-EA EMPLOYEE s50O OOO DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/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 t Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE C. 01988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S149786/M149785 MER - i�.'aS _•g'1 t.1'�.�c.3lr}F aaJC21.� l.: 5.! ,.. L :.Y . ': iiYYYY!!ll:�s����JJJJ3333JJ :-3 F.:3:t�e,u u 7 s 'lE. i3a:i.i ti i"a dnt.d 2 / t \ L4E<3'3C(�l.li.zXHftl z+t}dabl"tjtF'P S Lc;ense CS-009714 RICHARD P.GARNEAU.DR �. PO BOX 476 ` W West Barnstable MA 02668 ^fYF3i- 0410412016 , Office of Consumer Affairs idp Bus .ness Regulation e 10 Park Plaza - Suite 5170 Boston., Massachusetts 02116 Home Improvement Contractor Registration wa Registration: 162600 Type: Supplement Card - 73 Expiration: 312612017 BAKER & ASSOCIATES INC. .... _........ RICHARD GARNEAU w P.O. BOX 923 CENTERVILLE, MA 02632 Update Address and return card.Mark reason for change. SCA 1 0 2OM-05111 Address ❑ Renewal ❑ Employment Lost Card .. �:�e3 ((:'P?9G17LP7Y,fftll7l✓!Z I�C�/�LCt5617.t'fL1L1N�tct . #. eig e of Consumer Affairs&Business Regulation License or registration valid for individul use only E IMPROVEMENT CONTRACTOR before the expiration date. If found return to: y^ Office of Consumer Affairs and Business Regulation istration 1F2600 Type. 10 Park Plaza-Suite 5170 Expiration 3pZg/20i7. _Supplement Card Boston,MA 02116 BAKER&ASSOCIATES 1SIC, r RICHARD GARNEAU 521 SHOOTFLYING HILL RD — CENTERVILLE,MA 02632 Undersecretary Not valid without signet, The Commonwealth of Massachusetts Department of Industrial Accidents Ugce of Investigations :. 600 Washington Street Boston,M4 02111 wrvrnmas&gov1dia Workers'-Compensation.Insurance Affidavit:Builders,/Contractors/Electricians/Plumbers Applicaut Information ,l` _,p Please Print Lez bIN Name,Musmessiorgarrin ion individuaD /�i�De! r` ��.d f'/� Address: c� City/StatetZli g: line Are you an employer?Check the appropriate box: T of project(required). �. I am a general contractor and T Yl pr ,1 1.[�I am a employer with ❑ S 6. ❑New construction. employees(full and/or part-time)-* have hired the sub-contractors ?-❑ I am a sole proprietor or partner- listed on the attached sheet. 7- ❑Remodeling ship and have no employees These sub-contractors have g- ❑Demolition working for me in any capacity- employees and have workers' c insurance.4 9. ❑Building additione. [No workers'comp.insurance � required] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I ❑Plumbing repairs or additions myself[No workers'comp_ right:of exemption per MOL 12-[94kmof repairs insurance required.]7 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 sbnsving their wvzliers'compensation policy infosmation_ I lfomeownus who submit this affidavit iIIdicatmg they are doing all work and then]site aural&contractors must submit a new affadn it indicating such. r-ontmtors that check this box must attached au additional sheet showing the name of ttre sub-conuaMTs sad state Whether or not those entities have employees. If the mb-contmctors have employees,they must provide,their workers'comp.policy number. I am an empWer that is providing workers'congmnsadon insurance far my engko e& Below is the policy and job site informadam Insurance Company Name:Ai.t✓ Policy#or Self-ins-Lic.it: Expiration Date: a � Job Site Address � �1 ./ AWI City,'StaWZsp: Attach a copy of the workers'compensatioif policy declaration page(showing the polity number and expiration date). Failure to secure coverage as required under Section 25A of h'IGL c. 1522 can lead to the imposition of critumal penalties of a fine up to$1,50aOG and/or one-year imprisonment,as well as civil penalties m the form of a STOP WORK ORDER and a fine of up to S250M 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 c i er lie pains nd penalties o,f ' thatthe informahan pmvided above is true and correct. S. fuze" Date: Phone#- Z�K 93 V L d 3 lX Offireial use only. Do not write in this area:,to be completed by cite or town oacratL City or Town: PermitUcense# Issuing Authority(circle ogre): 1.Board of Health 2.Budding Department 3.Cityffown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 ti TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 10 Parcel r�S- Permit# 73� H� Ac (0 JS f - Date Issued Conservation Division l I off--. Fee es 4 Z Tax Collector f Treasurer Planning Dept. ' Date Definitive Plan Approved by Planning Board ' Historic-OKH Preservation/Hyannis Project Street Address 269 Winter Street Village Hyannis Owner Joseph P. & Pauline B. Weigand Address 269 Winter ;St . Hyannis , MA 02601 Telephone (5 0 8) 7 7 8-113 3 - PermitRequest Family room & 2 bath r F ' A Square feet: 1st floor: existing 6 2 4 s q proposed 2 8 8 s q '2nd floor:existing 6 2 4 s q ' proposed 0 Total new 2 8 8 s q ' Estimated Project Cost $17 , 000 Zoning District Flood Plain Groundwater Overlay Construction Type Wood frame Lot Size 5, 000 sq ft Grandfathered: ❑Yes 9 No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ • Two Family ❑ Multi-Family(#units) Age of Existing Structure 70 yrs . Historic House: ❑Yes 1 No On Old King's Highway: ❑Yes No Basement Type: Z] Full ❑Crawl , ❑Walkout ❑Other Basement Finished Area(sq.ft.) `0 Basement Unfinished Area(sq.ft) 624 s q f t Number of Baths: Full:existing 1 new 0 Half:existing 0 new 1 t Number of Bedrooms: existing 3 new 0 Total Room Count(not including baths):existing 6 new 1 First Floor Room Count 3 f Heat Type and Fuel: ❑Gas J4XOil ❑Electric ❑Other Central Air: ❑Yes KJ No Fireplaces: Existing 0 New 1—gas Existing wood/coal stove: ❑Yes 6 No Detached garage:EXexisting ❑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 i Proposed Use' BUILDER INFORMATION Name Jeffrey M. Conrad Telephone Number ( 508) 771-8978 Address 10•.Locust Street License# CS 009857 'R Hyannis , MA 02601 Home Improvement Contractor# 124074 Worker's Compensation# TMP 100 9 3 2 2 ` ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN 0 on--site dumps ter SIGNATURE. DATE _ 0*aq I��1 `� ,• FOR OFFICIAL USE ONLY —• PERMIT NO: - DATE ISSUED , F MAP/PARCEL NO. _ _ w l./ •cry' i. + • F • ` •• f . • i e - 6" ' -• ` f ` ADDRESS VILLAGE ` OWNER` • +• �~q� � — _ °• • 8 _ • _ •.� K.. . + As- DATE OF INSPECTION FOUNDATION - FRAME , INSULATION _ t x a f _ FIREPLACE Yti - a ANV ELECTRICAL: ROUGH '. FINAL' PLUMBING: . ROUGH FINAL i r GAS: ROUGH FINAL FINAL BUILDING''.L DATE CLOSED OUT _ ASSOCIATION PLAN NO. j _ 1 e own ot Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 ; Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Buil&g'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT 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. TypeofWork: Remodeling/addition Estimated Cost $17, 000 Address of Work: 269 Winter street Hyannis, MA 02601 Owner's Name: Joseph p. & Pauline B. Weigand Date of Application: March 29, 1999 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law C]Job Under$1,000 Building not owner-occupied [30wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY / I hereby apply for a permit as the agent of the owner Jeffrey M. Conrad #124074 Date ontractor Name Registration No. OR Date Owner's Name q:forms:Affidav _ _ _ The Commonwealth of Massachusetts ....... _ Department of Industrial Accidents eRE � ��T . -=�_�� Offrce afln�estigatians 600 Washington Street Boston,Mass. 02111 iii�,,••//a/a i:05:'!,,,,a./,,,.oi / / % Workers' j%% %/% ensati C rance%%% % %%////%� /////// nicnns�mf`a //,%%% name: Jeffrey M. Conrad location: 10 Locust Street citV Hyannis, MA 02601 phone# ( 508 ) 771-8978 ❑ I am a homeowner performing all work myself. I am a sole ro rietor and have no one tivorking in any ca a0tv ❑ I am an employer providing workers' compensation for my employees working on this job. company name: address: city phone#• insurance cn. Vn11cV# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name- address: dtv: phone#c . . . tnsornnce co. .....:... o rev#.. . ...,. ... .... comnanv name: address- •.. cit%7 ... phone#' ituurance co. --------------------- pill v# Fallure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Me up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a 6ne of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DU for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Date Print name Je frey M. Conrad phone# (508 ) 771-8978 official use only do not write in this area to be completed by city or town oftial city or town: permit/ilcense p QBuilding Department ❑Licensing BL d❑check if immediate mporue is required ❑Selectmen' nee❑Health Depment contact person: phone#; ❑Other (mvaec 9i95 FIA) 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 co=z= 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 receive: 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 cr 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 renew.: 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 Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industriak 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. 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 permittliccase number which will be used as a rieference number. The affidavits may be returned io the Departmeat 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 arty 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 @MCC of lavesagatloas 600 Washington street Boston'Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 780t34Rj Table JL=b(eondaaed) Prescriptive Packages for One and Twe4wn lr Resideadal Buildings Heated with Faasil Fuds MAXIMUM MINIMUM Glazing Glazing ceiling Wall Floor Basemeo< Slab Headrig/Cooling Awn'(%) U-valuer R value' R value' R value° Wall paimew EqWImcat EMpenc? pie R+value, R value' $701 to 6500 Heating Degree Dare' Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 85 AFUE T 15% 036 38 13 23 WA WA Normal U 150/. 0.46 38 19 19 10 6 Normal V 139A 0.44 38 13 25 WA WA 85 AFUE W 150/0 0.52 30 19 19 10 6 115 AFUE X 18% 032 38 13 25 WA WA Normal Y 18% 0.42 38 19 25 WA WA Normal Z 18% 0.42 38 13 19 10 6 "AFUE AA 18•/8 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: (o 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: L� 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a 780 CMR Appendix J Footnotes to Table J5.2.1b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft'of decorative glass may be excluded from a building design with 300 ft of glazing area. Z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example,an R49 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame ormass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned cmwlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 ' �' - - �IEe�000xmeavuuea� ✓�amae�uiaelta I' HOME IMPROVEMENT CONTRACTOR Registration 124074 + Type - 08A. _ r Expiration 05/09/01 l Conrad'Re®odeling Jeffrey M. Conrad , G��aMmo O;locust t ADMINISTRATOR HyannifAA 02601' k - YApasYo54.1`wY�'�`.. .�. w.w.,s++u r._ti.:'-,.'.rti. ....,�-,. _•tivi.rr.ar �-./.��,`.-�1') _. . DEPARTMENT OF PUBLIC SAFETY CONS TRItGTION;SUPERVHOR LICENSE a Number E,p:rss: Bitthdat2: CS ^mast ,023/1g99 1?_ njig5� RastrfctedfTa 99 , . B JC<ST f HYANNIS. 4A =)26@1 ` _ .r .— fir!' • .. ._..� ,,j•�� Joseph P. and Land In......ARNSTABLE - Hannis Belonging ro Pauline B:.Weiland• Deed In Book.... ......Page9.........l ....................................... In Barnstable Registry, of Deeds 4 Land Coget Certificate No. ...............in Book.................Page............ ............. ..... .... .......... I e r Land in Barnstable by Nelson Bearse, Surveyor 1924 {, f Recorded Plan... .... Date of Plan.......... .I Barnstable of Deeds,in Plan gook. 14 No:41 Filed Plan No. In.....................[tegiatry...................... ......... _ ......... .................................. x: MORTGAGE INSPECTION PLAN OHRENBERGER AND WOJCIK, P.C. L 269 Winter Street (Hyannis) Barnstable ; Loan No: "? lito� N { ,. t � A. ,y = Q TWO Y` Y ` l= WooD -N I �s Al..269 I •}I } PoRcN � �� � x<<. '> WINTER . STREET . s ' July 3, 1988� / Y • Scale V=20• • I CERTIFY THAT THIS PLAN WAS PREPARED F zv. IN ACCORDANCE WITH THE COMMONWEALTH t, - OF MASSACHUSETTS PROCEDURAL AND 1 k, �• EEC s TECHNICAL STANDARDS FOR THE PRACTICE OF LAND SURVEYING 250 CMR 6.05 AND WITH THE SPECIFICATION SHEET ATTACHED..HERETO • i Of ::_ o dlgl� F is ; ,je ANDERSON '^ — No.31298 o Y gECISTEaE� r �: �. L LAMS S i w CONRAD REMODELING 10 Locust Street - Hyannis MA 02601 E ^ r AN ZIO - y i r Fpoi' ._.:Zt P W-.16AW 0 �69 wrrlier� .S�c�c♦e�-- - - -y-YAWYIS.5 /yid _.� CONRAD REMODELING 10 Locust Street Hyannis MA 02601 -7. i - s � 1 " N c_ C o t I i i _ 3 1. 71 [jif Foa+' we,*5* v4 ►1PfOJ. y ` - �6q wiyAec- 4ree+ `. (D co Ujpor i i :r ,. . t •Y `WNRAD REMODELING 10.Locust Street Hyannis MA 02601 - n _ - �_._—___-_._.—_. _.__._._ �Y^'—�..._._. _..-...... _ T.�._..... _...n......._ -w-............ .+r�nv:r•.wr�n��.wx.-a.r._....�v.__r..�._._�.rv.._...++...n.� • � k'�SP��kf__:ii�:�(leg.1'Q_tY►A�t.�+.._.�.x�S�'i�N_��_ � t OA'43ti0 3°I ^ M 1 i 1 4 - i fpot' �/V.�.. t.:.� � •► .'�c�t-- --- ----- . tY+PWe%G►awp ApP.o,. ___ yiAww•5 M-4 _ CONRAD REMODELING , 10 Locust Street , Hyannis MA 02601 r. - _ g , al rc Rom ; 6/11 t w w,V.A e� ��+ IA,!Ovovo( 61 -� W&RAD REMODELiv6 10 Locust Street Hyannis MA 02601 17. I,�x►� LOW tC O YU 1- n a' • - /��" w 'I� 0G1 )1 _ Y` pp''W I > t r # t5' I �� IW' I'�'�7 r1e��A�JC�I. f�II�..IC�:�.L�1:�u _ ,I �� 1 •I 1 pp Y -5 � rfi •, 2. !" SELL. Se�►L 1X(s �� S� 1..� �, z 1 \ l n VGhyF N Ila - K 1 dVA Z l e