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Home My WebLink About0335 WINTER STREET 1 1� g ct i I�i �� (� .L.o ___�= aj TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION oF BAP Map J r Parcel UNSTABLE Application # 2015�.� Health Division Date Issued 0'?�� Conservation Division Application Fee �y r Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 3 3 ._ C�,� Village / s9-ry�✓ts Owner -�-:2/1 �. �9'�vG SrLiiT� Address T Telephone Permit RequestsvvF_ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 7��onstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family /1-11 Two Family ❑ Multi-Family (# units) Age of Existing Structure /R50 Historic House: ❑Yes,7E�No On Old King's Highway: ❑YeS�o 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 Room 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: ❑ 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-INFORMAT-ION --T - — - T _ (BUILDER OR HOMEOWNER) Name Telephone Number Address � _ /�,� License # /",Z_ Home Improvement Contractor# 1 v2C5s Email 6¢ ��= /�G��O.'�G%T�- Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ��i'ei�OyT�i /�i��fG G=�C s/��/ai✓ SIGNATURE DATE ��5— 1 FOR OFFICIAL USE ONLY -APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ti DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATEuCLOSED OUT 4 " ASSOCIATION PLAN NO. i TTw Co1nma ns€ ih of-Vassachuseffs 1 Dellta'lI{tm t of l7IF bLS&ial-Accidents - - Office of r �S UZans 600 Wask ngton Street 14 n w.malsmgoTMis Warkel<s' Compensation Insurance Affidavit$uitders/ContractorsM4ac-tricianslPlumbers Applicant Information Please Print Le?,ribly Name;(Busma�oxganizgiou fndmidnal)= (� rr¢/J�L S ?l5 f�C'i/� �✓� Address-- City/Stat&Zip- �i�414:r 0 1 s� � Phone 4- Are you an employer?Check Ilk appropriatebo= Type of. ect r 4. I am a canfractor and I �°] ��1��= L❑ I am a employer with. � 6- E]New oonstruction ` employees{full and/orpart-time}* have hire4 the sdb contractors. 2._❑ I am a sole proprietor or partner listed on the attached sheet 7_ ❑Remodeling ship and hate no employees These sob-contractors have g- ❑Demolition workmg fvr me in any capacity employees and have wodcers- mi 9_ Building addition [No WQr P1S' C4mlp_in urmce comp_insuran 5_❑ We are a corporation and its 10.0 Electrical repairs or additions required] officers haiim exercised their 3_❑ I am a hom�wner doing all wed- 1I_Q Plumbing repairs or additions, Myself [No warkers'comp- right, , 1(4), ad per ime n 1 Roaf c_152, 1 and we lra�a nog ;�,r;,r.-�ce regnimd.]F § {�' employees-LNq wormers' 1 0 Other comp_insurance rNuired-1; *Ary anpticaat that chedzs boa W 1— also fill ont the section below showing Their-waders'compensation poliLT iufi T Home-awmiers Who submit this affidavit mffcating they am&mg aII vrc*and lea hire oatd&contractors nmsi subant a IFew affidsrit maaratm mrEL '=tncmcs dw rTiWA this box mast attached as additional sheet shoxmg the nsme of&e sda-oars and scalp uhEt1w ernot tbn&e Entities have employees- If the snit- a31tractars hsre employees,they mast p-rAe their workers'comp.policy nmnher I am ara employer that is pravidu:g workers'compsnsutio.n irmirance for my employee-% Belaty is the pa7icy raid job site informat&w— Insurance Company Name: Policy 9 or Self-ins-Lic-& Expiration.Date: Job Site Address: Cify/Stat Zip: Attach a copy of the workers'compe-nsatian policy declaration page(shy the policy number and expiration date). Failure to secure coverage as regturedunder Section 25A of MGL c. 152 can lead to the imposition ofcriminal penalties of a fine up to S 1,540_0(Y and/or oneyear-imprisonment as well as civil penalties in the fours of a STOP WORK ORDER-and a fine of up.to$250_€30 a.day against the violater_ Be advised that a copy of this statement maybe forwarded to the Office of IIItesttgations of ffie DIA far insurance coverage 4 cation- 1 da hereby aerfify under tks pains a penatlies ofperlury thatthe irt,formtifian prati&d�a&n t is bus and correct Sitmattme: Bate: Phone# Offuiat use only. Da not write in this ureic}to be camped by city or town ofji'LiaL Citg or Town: Permit/License# Issuing Anthority(circle one). 1.Board of Health 2.Building Department I City(rovm Clerk 4.EIectrical Inspector_S.Plumbing inspector 6.0-thtr Contact Person: Phone#: r 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the 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 IocaI 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 vrith 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(LLP)with no employees other tl a 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 a,$davit 'I1re affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Deparbnent of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtau-i a workers' compensation policy,please call the Department at the mm�aber 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 spat:at the bottom of the affidavit for you to fill out in the event the Office of Investigafions 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 permitllicense 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 Ibis 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 Coa maaweal&of M ssachusets Department of Inclustrlal Accidm s €}ffiee Qf Vestintioar, 640 Washingtan Street Boston,MA Q2111 Tel.#617 727-49-Go ext406 or 1-9777-MASSAFE Revised 4-24-07 Fax# 617-727-7-149 www.mass_gov/dia .7 Massachusetts Department of Public Safety. jq: Board of Building Regulations and Standards License: CS-086733 ' Construction Supervisor 5m; CHARLES PISACANO PO BOX126 HYANNIS PORT.6 Q i Expiration: Commissioner 07/29/2017 1 •C/ize�ar�urr�a�aulec�CC�o/Gy!/LadlCcc/etcAeL�1 , Office of Consumer Affairs&Business Regulation IMPROVEMENT CONTRACTOR krl�E gistration: 179053 Type: piration: 6/17/2016_, Individual CHARLES PISACANO CHARLES PISACANO 73 HARBOR BLUFFS RD i HYANNIS,MA 02601, Undersecretary i License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 / Not valid without signature Construction Supervisor. Restricted to: Unrestricted-Buildings of any use group whichjenclosed less than 35,000 cubic feet(991 cubic meters)of space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit:1NWWMASS.GOV/DPS 4 r. fAE?QF+TASZE,:'' p� bum A Towrn. of Barnstable Regulatory Semees Richard V.Scab;Director. Bulldina DiviSian Thomas.Perry,-C)3O. Building Commissioner MO Main Street; 11yannis;MA02601, Www town barnstable.ma.us Office; 508-562-4038. Fax: 508490-6230. property Owner Must Con plefe -arid Sign This Section.. If Using A Builder as Owner of the sub xo J F PAY hereby authorize Charles:Pisacano to act onrriybehalf, in all matters relative to work authorized by this building permit application for. Y 335 Winter St,', Hyannis, Ma.02601 (Address of Job.) z � 5 Signa.tute of Owner Date Print Name, If Property Owner is applying for permit,please:compietelhe Homeowners License Exemption Form on the: reverse side Q:IWPF7LESIFORIvLSlbiu7diagpetrartformsll:XPRESS.doc Revised 061313 f F7 , MI Wd I OSW'a►ICO Gard l liwapca.Gra W4' Hk. r AC ap tE:RTIFiCAYE OF LIABILITY 114SURMOE D6��;�i �.- ;:::' THIS CHiIF1 'nFr_=Ik ISSUED AS A MATTER OF INFORMATION ONLY ANp'CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS t { `: CMTCATE DOES`NOT AFFfRRMTNELY.OR NEGATIVELY AMEND,EXTEND OR ALTER THE Ct�VERAGE AFFORDED$Y THE:POI ICIE$ I=•,. BEt,OW. THIS.CERTIFICATE Of INSURANCE DOES NOT CONSTITUTE A 00H7RACT BETWEEN THE.ISSU NG INSI W(S} AUTNO o REPRESENTATIVE OR PROOLICM AND THE CERTIFICATE HOGDER.. IMPORTANT, N tha.ce"tcaU holder Is an ADDITIOR&INSURED,the poYldy(Ier,(a+u bs elhdoi' ,w It.SUBf"71pN IS WAIVED,subject to -. the Berms and eondkions ottlw policy;eerfatn pe0des'mey.4w.an emtorsahneld. A Sdeterrhent on this eefNttpte dads not eofYf6Y'tlghts to the 4roM ale:holder ht lieu or surah-endorsem :PRODUCER - - COWAC OBRIENS'CENTERVILLE INSURANCE AGENCY:INC;. P O BOX 610. ablw Centerville;MA02632 AQ!? - .W9tSRFJt(tij AFFOROING;CCVBRA�CiL' MAICB.: . IrRfvliEa :. . .. -. ]OHN BRAOY INSUHER9: AmGUARD,:Insurance. 42340 t IgSURER;: 226 CASTL[4Vo00`GIRCLE IHSursRe # FIYANNIS,MA 02601 I SURERE JMSURFRF COVERAGES CERTIFICATE NUMBER: REVISION R � or THIS 15 TO:CERTWY.THAT THE POLI �S'OF INS1fRRNCE LISTED DELGW HAVE DEEM lSSL'E�TJ TNE-WSUREi2 NAA7EU, V`fLi1 THE PQLIZY{PERt4Q MrCATED. NOT'MMTANDING ANY RFWIREMENT.TIMM,OR GONDiTM OF ANY CONTRACT 011 OTHER DCx:ll n WITWmi ECi' �TH 70 ri I.4 F•MAY BE'.15.77 PE 1FD O2 MAY HI'ilIN,THE IMSiJPANCt AFFCIRDEU HY'THE'PUIJCi rK;Tt.l. 'EXCWSIOISSANDt6AIDRION50Tii11rIIP(XJCiLF I.I1NlT6SlICtWNfWAYIIAVEBEI•NRF,[R10EDNYPP.10f',tACr1S L� 1 r,y`,�ry FIdR AD�-SU61F PaLICY EFP IPoucx.Fx� i„r, LTR TWO V;IR6NFAACe -�j PCLLCYkWB97 y(raawhurrrrJ 4 4w - GEIVEIIAl1.WWury CpygaERcljw OF.�ERALUAEPRit� �� oca 1'+ �. D. s+ S` Y ue , Mi'Ii�Y Y AGGREG41t �� 0 ! h wLaou�rti soh? PArss{F' 0 e.ML AcitrDait sim t APPI iLs Pki2; _ — . ' ALRt1Na&LE UAMITY" ••.. . WMEM,I or- 6�DiLruLURriPcr.P�+W r Au;a-vec sarttni 0. enml.Y-fNJURY(F.;&z TCS Aunt» _ YDIdlPA4YEa •-'�hiY - MnEL AtlCls: Amps:_ t �k .. IPerum+CsILLI f: .n f U►ER@Li.JLLWB.'._ .. .. .. - - EA"�KCURRa=n'CE. - 17CCES3LWD (�.Pi1r6�A.1�.' ° 00, .r ,AGGRE�AiE 3 r..Hri' REteurWR 9IG 4 §'s f WMWERS CCAMSAMN kM MKOYERS LJR61LrTY AYYrN�''ibETC.fi.'PAFTNEWEJ�LUrNe Ylq,r?. EL641k:ICE.Aj f f;UO DDU 8 F.C.7n&WMEXCLLME 2R2WC5��8% t2/3Q12014 12l30r201$.I prarttl:tory n htHl ��}}} P-..L MMASf-VA Fnur or f 100.000 .. {?y,...s.'�,��' E1C156A5fi-POLICY UAST 50U.I10D . I 1. ate DEsa0Pit4X1 OF OPERArIQN q=TdC{NS':t S - {140R0'10/A#Mlo"46m 5clfo•WIE.iroowspaa is:apNiod}. -1_ - r ExdastorisAv ]OHN BRA A J 1. \\ • .� i fib 114, .�•.y, ;.. .. CERTIFICATE HO jiN� - _.. -. CANCELLATION , . SHOULD ANY OF ENE ADDLE OE5Cii8ED POLICIES BE'CANCELLED BEFORE- ! s, ' THE EXPIRATION DATE THEREOF. NOTICE' :VAL BE `DELNEREl7 IN n - Frank lVD'7�C5 .,', - 'ACCOPOANCE iNIrN tNE-PIN.ICY PRDVII,y01q." 64 Enterprise Road HYanniS,MA 0260Y' AiiihaalFeoh:FaRESExrATnf. I t988 201.0 AGORD;CORPORATION-':AU rl ro"rVad. ,.. ACORD:25(201D1Q5� The AWRD'narne and logo"arOreglsleredmazks o ACORQ'. i