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HomeMy WebLinkAbout0306 WINTER STREET 301� u1 , n -ke fit' I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t�oIO 60 /3 Map Parcel Application # � pp Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic -OKH Preservation/Hyannis Project Street Address 3 D wr�e�e aL Village 5 , ��Q _ �02 0 Own( War, S-��( Address Telephone T-O &' 77S— D 9 3 3 Permit Request Square feet: 1 st floor: existing kV proposed 2nd floor: existing---proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation`$p�30d Construction Type X, -4 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: a'Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 7� Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel- . as ❑ Oil ❑ Electric ❑ Other Central Air: es ❑ No 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 A eals Authorization ❑ Appeal # Recorded ❑ �' Commercial Yes ❑ No n If yes, site plan review# , Current Use Proposed Use - r .aa APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name / Ol ce Telephone Number ��1 �3 c4 kd Address ¢ License # C T � Home Improvement Contractor# - Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE /G FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINALE PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT . i ASSOCIATION PLAN NO. 4 ' r f The Commonwealth of Massachusetts Department of Industrial Accidents 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 Le 'bl Name(Business/Organization/Individual): Address: y Ct c S -�- City/State/Zip: (G4., —v,Z 6 1,9144 g2263o2Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I e oyees(full and/or part-time).* have hired the siib-contractors 6. ❑New construction 2.W l 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' 9 ❑Building addition [No workers'comp.-insurance comp. insurance.$ required'.] S. ❑ We are a corporation and its, 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. oof 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 scction 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. tContractors 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 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.Lic.M 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 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 certify under th p zpvandjyn3Aies of perjury that the information provided above is tr _and correct Si ature: Date: Phone#: 3 2-,*PCB Official use only. Do not write in this area,to be completed by city or town officiaL . I "City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4:EIectrical 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 enterprise,and including the legal representatives of a deceased employer,or the the foregoing engaged in a joint g g ep of g gJ rP 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)narne(s),.addiess(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 r 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 fo any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts 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 I 7t 7t hAUL K 4 MARSHALL r 7 General and Preventive Family"Dent►stry'_ _ t s "� December l5th, 2009 3 j rTo Whom It May Concern t We give Michael J. Dmoia permission'to complete construction work on the property 2 t ' located at 306 Winter Street,Hyannis,Ma '02601 j Paul K..Marshall; II D:M D }- t [ .�) '.� — -J - K dam• - - _ , y - • •c � "i - `` v 306 Winter Street, f'.0.: Bo'x 934, Hyannis, Massachusetts.,02601 F,• (508) 775-0233' Jan - IJ. LUIU J :41NM No - 1114 P . 3 ,N Town of Barnstable B&=;rA $ Department of Public Works 367 Main Street;Hyannis MA 02601 ht*tp://www.town-bamstable..ma.us Office- 508-862AO90 Mark S.Ells,Director Fax: 508-862A71I R.W."Bud7 Breault,7r. Asst Director SUBJECT:Numbering of Buildin s Map No.�Q Parcel MO._ 1` f� Date:,/AA _/3 Dear Property Owner, Notice is hereby given in accordance with the General Ordinances of the Town of Barnstable, Chapter III,article V,Numbering of Buildings,adopted March 3;1931, revised July 21,1994, public convenience and necessity requires the assignment of number--,K04., for your property located on 1' STREET NAME VILLAGE This number should be affixed to your building so that it is visible from the street as outlined in Exhibit"E", Town of Barnstable Rules and Regulations for Numbering of Buildings.. Please contact Mr. Frank Schlegel at the Engineering Division at(508) 862.4085 arld be prepared to provide all telephone numbers at this location so that your E-911 account records can be confirmed when the correct building number is posted.('-jc f- Z } Robert A. Burgmann, P..E. Town Engineer encl.'— T.O.B.Rules &Regs, _ Common Questions _✓Site Map _ Aasessors Change Form Jao • 13. 2010 3 4 1 P M No 1114 N- 4 " •w- arcel�dit Page 1 of 2 Logged In As: Wednesday;)anua Frank Schlegel Pa rceI A»plication Center Road System Reports Road System The record has been updated. Parcel Detail Parcel ID: 310175 Sewer ACCt: 854 T/R F.• 'Update Devel Lot: dwnPf: KEPNES. E�ENJAMlN & RUT H Co Owner: C/0 MARSHALL, PAUL K Street: P 0 8OX 934 City: HYANNIS State:, MIA zip: 02$01 .... ...._. Location POTWINTER STREET village: Hyannis _ Road Index; 1866 ..: . Pri Frontage: 50. :.. .. . . To Set r=4 you can also enter road index and tab out of field. Secondary Road: Sec Index: Op00 Sec Frontage: visions Location: 31$VYH► TwR STREET Last Updated: 1/13/2010 2:2518 F No. 81dgs: 1 Account No: 227436 Lot Size(acres): 10.15 State Gass: 342J Year Added: 1967 Fire Dist- Deed Date: J. Deed Ref: C7033� Land Value: 88300 Bldgs Value 129300 Extra Features: Condo Complex: Building: unit:' Update VMKIMLNt OF PUBLIC WORKS- . ENGINEERING OIYISION 367 MAIN STREET NYANNIS;MA 02601 a. y � � ri �l i I i 'Rai WIMER • �=• =� � • � � • �ST R ET IS , , , C) o semaps.dgn 111 31201 0 2:30:03 PM cff ore tir q3;o!.+:lnjj7 p irro"s on�yr matt t���►uit tfq)FDs(I)t Facttritl rtltAl�t!f!!:ft1f1G In Phyalcul objecLD -'� Massachusetts - Department of Public SafctN Board of Building Regulations and Standards Construction Supervisor License License:'CS 58441 j Restricted to: 00 MICHAEL J".DINOIA` { i 32 OUTPOST LN ; CENTERVILLE, MA 02632 Expiration: 10/15/2011 t Tr#: 4963- - Commissioner t .