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0056 ELIJAH CHILDS LANE
a ,a , v ,. Town of Barnstable u1Cllri i Post This''a So That rt;is,U�sible.Frpm the Street Apprpved Plansj,Mustsbe Retained On Job and 'his Cya"rd"Must be Kept, „ .�arrsras�.e. • � � "�Fnal�lns�eetion�`Has:BeenMade ffi ry � �r � � �' � ��� ermit° 'Where•a.Certificate of Occu anc �is�Re wired.ouch Buil'dm' shaliyNot�be Occu led until a�Etnalan!s"ectianhas beengmade r ►Aid ": .. •:�a. ..,. ...�'•.'., &. ,,",bx,;.,..:;p�.�,.�y �., aq r ' .-1�. his;... ,gE ,�. .�_,..� .,r.. ;S.�„y ;p..:z: -.'.. .:?�.^• ..•T�,.�...�c:;p��.. r;.� .�.fir,a>. .", .4. '�•,1.. Permit No. B-19-2135 Applicant Name: RICE, DAN B& PATRICIA STARK Approvals Date Issued: 07/02/2019 Current Use: Structure Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 01/02/2020 Foundation: Location: 56 ELIJAH CHILDS LANE,CENTERVILLE Map/Lot 171 254 Zoning District: RC Sheathing: Er Owner on Record: RICE,DAN B&PATRICIA STARK Contractop�r acme Framing: 1 Address: 14 PARK PLACE Cont actor L�sense:� 2 '"�� Est Pro ect Cost: $0.00 RAYMOND,NH 03077 = i Chimney: Description: Shed 10x12 �, Permit Fee. $35.00 h � Insulation: ee Paid " $35.00 F Project Review Req: Date 7/2/2019 Final: ( A .. l� Plumbing/Gas Rough Plumbing: Building Official X. ••., Final Plumbing: This permit shall bed11 abandoned and invalid unless the work authonzed by this permit is commenced within six monthsafter issuance. ;. All work authorized by this permit shall conform to the approved appl anon and theme approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structuresshall be in compliance with the local zoning by laws;an�d.codes. g This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final'Gas: work until the completion of the same. Ov, . The Certificate of Occupancy will not be issued until all applicable signatures Building and Fire Officialsare provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work � � % Service: 1.Foundation or Footing " 2.Sheathing Inspection �� Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed'" 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: i Town of Barnstable �G Building Department Servi(4 �O Brian Florence,CBO MASS. Building Commissioner 1639. �� 200 Main Street, Hyannis,MA 02601 '9 ra2 '0;A A Eo www.town.barnstable.ma.usbi 9 Office: 508-862-4038 Fax: 508-790-6230 PERMIT# FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less Location of ed(address) Village Property owner's name Telephone number Size of Shed Map/Parcel# E-Mail �io r 10 yye$� 1sf 20I SigAA&e Date Hyannis Main Street Waterfront Historic District? ll�� Old King's Highway Historic District Commission jurisdiction? N' O You must file with Old King's Highway Conservation Commission(signature is required) to 0 Sign off hours for Conservation 8:00-9:30&3:304:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:08/6/17 POO r - All T T�K ra.. �30., I C `i 79. r Pf AL PIT Fir, Fw e.-,.<� .Q..•4r!.�*. �7lli� M VC+�� E ,�.y t r.J r Y i -{ ��' � , T. i � 30� pt?Io u�1A 5� �`�Tt•- �" c r t _I. .PIT�•�a t Ott inT . -•r ii i•{ '': F ..•`7"il '1 �e. �.t ^9 i.,t.,�' )_ t--I _I , •1 ,� 1 _._ ,_•._r..w .[ � F •._�_j.a.:.. 1 � i a- F � a t�son °�r #- -�-I�:.! � , r�-�--t ,; a 2 ''3•'•;r1:1 f � �- ._.t. �� `�. .o _; ; �1�:� ,� .f• , �. iw. ik #sue+i}•.d Y-,.iF-.--1•�l L� J t_y, �' , �... } {i i+. y t rdt '•1, i.,} _s.-a{.}�t;-3a• <<y z -r-�i _. •.. ..-.;- _ }� �-" _� , � � S.>. t+afv',,.-t, .}s � -r= -i.-i..' s1 •- , -:-: � - -. ltL"N�ti� + Atq •` �. t,. a# 1 w� 'r� ,�,,� %" ,= 1- ` -�tt t_r.}. 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C............r.............. . 9 `e QTH TITL °o 1b q. � } �; ODE D3MAI TOWN OF BARNS e�{ r "� LATION /J. f y Y v f9 �. trw• M BUILDING . INS'PE`CTOR fi , o APPLICATIONFOR PERMIT TO ..... ....................................................................................................................... TYPE OF CONSTRUCTION ........;° sB ........................................................ ...................................... { . ....L .... .................19..Y,/ TO THE INSPECTOR OF BUILDINGS:` The undersigned hereby applies for a permit according to' the following inform tion: . :. ..Location ....... ... ............ .... .... .................................................................. a ProposedUse ......... ...............:........ ........................................... ..................................... ..... Zoning District ....................................... ...............................Fire.District .................. ... Name of Owner l.........��: .... ................. Address ........ �� ............� ......�� .......................... Nameof Builder ........ .......................................................Address .................................................................................... Nameof Architect ..................................................................Address ................ .............:................:.................................... Numberof Rooms ..... .............................................::.........Foundation ..... .:. �...................................................� 4 Exierior ...... ..... ..................... 4 . .. . .,.... .:! .............................................Roofing ....: �!s�t !. � ,.,', . . ....... .... Floors .. � .........Interior Heating ................Plumbing ... Fireplace ....... ..WO, . ......... ........... ....................Approximate Cost ... "'.! n!..�. ...�........... Definitive Plan Approved by Planning Board ________________________________19________. Area �. �! . E '......o................ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH o • • r: 4 t I hereby agree to conform to all the Rules and Regulations of the TowD of Barnstable reg r ing the above construction. Name ..:.. ........................... ..... ........................:................ T ` S8Q&�JL, ALA�[ E. ^ " ` r 2371.9 One Story ' ,No ---.�—.. Pe for .................................... � . . ^�--.Sj)\ ly.-Dxalliag.----. � � ' Lot #56 56 Elijah Childs Ln, Location -------_-----.�---.---- Centerville � t -----------.� -----.. � | Alan E. Owner ...................................."�"�� ------ � ' ' Frame . Type" of Construction .......................................... . . . ^ ~ ' , --...—.-----.---------./.------ Plot ---------. Lot ----------' ' ' ^ . ^ , ' Pennh G,onna6 .......... 81 Date of Inspection ------------lA ' ~ . ^ ^ ' ' PERMIT REFUSED . '. l� ' -----,---.—.----------.. ' . � ----.. ^- .. -----------. . - . ........................................ .------�.—..—..—..^.----..~..---... . . . � .------.--.—~—..~..--.._.---.—. - . . ............................................ lg '-r,—'-- —�, ' , � . : .--.—. . — �^—. �.—.;.---...... —..------� ^ ' -------.. . . . ^r �`� ,r,"�! r r ^',a A•` L ._.� ' t .•Y jj p ` r,-� Vr n J '�ts. TOWN-OF,BARNST`ABLE` Perm£it Nod I t Building"``Inspector �r DAMS&&c a Cash+ :: i �P YPY OCCUPANCY PERM T Bond 4� Z/ "No building nor structure shall be' erected, and,no land, building or structure shall be -used for a new different,:changed, or',enlarged use .'without `a Building• Permit therefor ' `first 'having been obtained from the Building.Inspector:•No-building,,shall be occupied until a 'certificate of,occupancy has been issued by. the Building Inspector Issued,to Alan E: Snta� •Address a Lot #56 5`&. Eli 1-aiz iChildsI,n. Centerville Wiring Inspector- r. " Inspection date A "& • 1 3- ` Plumbing Inspector �� �' + Inspection`date's Gas Inspector [ _�.. Inspection date , ` ' r X Engineering.Department ;� l Y ' / Inspection date THIS V PERMIT WYLI. ,NOT`.BE VALID, AND THE:BUILDING SHALL�`'1V0� BE.:OCCUPIED UNTIL SIGNED BY -THE BUILDING INSPECTOR UPON.' SATISFACTORY COMPLIANCE '.WITH: TOWN' REQUIREMENTS 1 Bu�ldmg✓Inspector a Y - , . .. _ _. .... .. .... • k ,. .`L. ... 7xj �• ,..,z .. ...... .n.—•.r.Y.,._ .:,'8 ry.c•n.a,..` .. .. .....�.,.. ._s i • 1VI�• ;.. LIE?'G�rz�AG�` F�if try. �ct�-! �=i..owt� r;c o x 3.:4.. ,3�0 .p t� ' :, l l � i �, � ` � �' ' �.' , ' • frcc 'rtic. _ 3o�.tSc4.9Pv l r� '• `yf F 1 t +77 � r Qfi t,!-;V.1'\ F.J\.1G� 6 `J� • i t- + 1 fF .!f + ;j r t ' i 1< Afft t A L� vis;t :L2hTE. I f eC-D"T,1Ot 1. Off, 1 i' t-..} , 1 } ,l -• } y � +;, s nII t � , .. ti+ 1 d+ f + �'}_,r �c�t�H(L i...f " 1» r til I_.. i i I 't -. 1••.-1 r. p....�. ,.a+, ,+-=p..: �k�. '�S- ti-�>r�- �'- �r� , 7 —r-^y'-'+-"-y—t, i -'—i-- -5-- __ Y t i 1 i ,� , , r t' '� a y..:' , ti rf-.' 1 r..it Gi ��.•`. !.-f; r`il 4lI 7 ...: i r-. .. .,_, j,, _ i , ..-.x ��„ r ,�.. d I �.. ( r{ 1{, rt� .•r #-i .}.. }.<,!r r ', r_`l} .'_i- ' r ���in. �. '_ ' � ,�,�P r� i .i... � ,, 1. }} , }r r-t �,�•�{=s- ri�i-.--}�+ *1..: {,�i. �. { ; j � • .g f 'S! r i t' r LI i t y.1 i F a -{ c.:�,1 � z °i7i�•I Y pr. r t '* y .r 1', " i� } 7sii"1 t'r t'•cn ! s-} }•e,-.V t r ft .;x.. ..t t..1�._ c �t t ; 41 1, ..i , � � ., }+ �fc.��� t � T— r r �«a,' •r.g i Ir•Tt PF` t +} ,=r-� 1 r r 4,w •.„ �;{I i�7 +€v-�{"f i' dt.�' f. f i �t� , i a I. , , ,��\,; y, �. a 1.-1 .a., y e�.. .,:,,a }i ,:.p } ��al F•. , :'. , .y. „ J. t - t 1 r t � t t -r �j t"'f tiY { .Lp '+: t -r• i ; � W', � 1 ` .� _� i 1 rr` A�t t-{ �� i } t,•� 1 ;T'o� �►1C�o f '�' J 1 J _ , oz.; i t• t } ` }\"CS'7i / r -i IQ k t .: .. � _._.�._ -. .-,...• ,... ?ram! :.. ._... ��� `\1 O+__a ._i,..i 4r��. _ _ :r+l ,.... _ 1 -..-J 'lips t 1000 } A - - r t •o'er� � ; J } c► +a r } rst tt. 1 �� ) - I STozxi a�� • � { :P€zo�'t L�, i ..�M1 4 +Y t t) 4 a � d ,� Ttio� r r , - ,3 .4 T ► 1 1 r' "�•+ T 6:Gt2'TrIF T� 7 :0t-�f�._��✓� S{ lt7.d .a. s -. ... -. S r i _ t••iE. t��sa9 Gc�vt,Pt_�!S ITti Tt-a . SIDL-: 1 ss . f\, °�'t-lt5 t�C_�4-1 is � IoTASCp �c-� AI-.' o zTE�'.vtLLG O MASS. t�.1St"C'v.�C_��t >" �,vc,.i �f • ^f+tC:. cat~C,c_:'.T�, ��IcWLr-> Ati3pt_t �A;tiJ't_ �•- .E�r �,G c r>Cr ru l7e:re Mc►!�- Lcn C' -'t_tN - - - LAB -- A.LL �Ntt , 1 aiiYr - . 0•: l Childs56 Elijah • ••: w t� ''.I i 56 Elijah Childs Lane 10/4/2008 i Iz , E' 56 Elijah Childs Lane 10/4/2008 r s A 2,4 56 Elijah Childs Ln., Cent. 8/21/02008 00 k i t.I t 56 Elijah Childs Ln., Cent. 8/21/02008 v a P d. r • • 1 11. a' k d • • i 1 IIi liell PF 56 Elijah Childs Ln., Cent. 8/21/02008 a� fi. ass;` 56 Elijah Childs Ln., Cent. 8/21/02008 F • • i • L• 56 Elijah Childs Ln., Cent. 8/21/02008 Assessor's, map and lot number ............................................ P ��-- ?NE Sewage Permit number ��....7 ..................................• ..�j.....�........................... ZO NAM L House number r t3tn O 1639• `0 a MOX a' TOWN OF BARNSTABLE BUILDING INS P CTOR r APPLICATION FOR PERMIT TO ......:...r .. ......................................................................................... TYPE OF CONSTRUCTION .... . ... ........... ............................................... ....................... .......l.l . . .................19.(,� f� TO THE INSPECTOR OF BUILDINGS: The undersigned here applies for a permiording to he following inf tio n- Location ............. . .... .... .. ..... Z .� ................ .... ........ .L..... . ............... ............................ / ....... .. .�� ProposedUse ......... .. . .... .. . . .. ....... ...................... . ............................................................................................... Zoning District .......... . ..... ..................... . .. ......... ................Fire District ........ �.. ......... . . ....... . . Name of Owner ... .� . .��J. ... .. .... ... Address :........ .. /�� .�yr4-1C. ........... ... ./.... Nameof Builder .................//...........Y........'�/...................Address ..:................................................................................. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ............... Foundation ..........4,4- �.................................. Exierior ....................... .................... ...................................Roofing .. ............ ................ Floors ...............Interior ..............(J 1` Heating ..................................................................................Plumbing .................. .... ..................................................... Fireplace ..................................................................................Approximate Cost ...... ..G. ..��,.o....................................... Definitive Plan Approved by Planning Board -------------------------- 19 ----. Area . ...lf��0....•.,,.,•.,,....., Diagram of Lot and Building with Dimensions Fee — SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .............///............................................................... SMALL, ALAN E. A-171-254 — 13 5- No ..23719 permit for ... ne„Sorg,,,,,.,,,, Single Family Dwelling ............................................................................... Location .Lot. �A5 .....56 F,1.?j.sa.1...Cb.l ids Ln. Centerville ............................................................................... Owner ...Alan E. Small ............................................ Type of Construction ...Frame ............................ ..................................................... ........................ _. Plot ............................ Lot .....�........................ Permit Granted December 22, 19 81 Date of Inspection ......... ®.......................19 II' Date Completed ..........:...........................19 x 1 � . PERMIT REFUSED I ........................... ............................... 19 ............................: ................................................... ................ s0............................... e Approved ................................................ 19 ............................................................................... ............................................................................... of Town of Barnstable �S ePermi Regulatory Services ��6monthsfrom issue date } FeeMASS / * szasr.� �b 3 `b� Thomas F. Geiler,Director pr�NJ- Building Division Tom Perry, CBO, Building. g Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 ENPRESS PERAffT APPLICATION - gESIDE�U, ONLY �' S08-790-623 0 of Valid without Red X-Press Imprint Map/parcel Number i Property Address �i ❑Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address {(1tivf Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance " Check one: , ❑ I am a sole proprietor OCT 2011 �f I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurarce Company Name ` ` i Workman's Comp. Policy# Zopy of Insurance Compliance Certificate must accompany each permit. 'ermit Request(check box) ?.Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value . (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc, ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the=Home Im rove en on-tractors License& Construction Supervisors License is required. NATURE: /✓� Z-4 VPFILESTORMSIbuilding permit s1EXPRESS.doc ,,ised 070110 l The Commonwealth of Massachusetts" i Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass,gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le2lbIy Name (Business/Organization/Individual): n an t � e %f �f " r' Address: �'/e; � C Lt i� � ��tcl' 1� r�ll� J -��rl�'�i City/State/Zip: Phone #: Are you an employer? Check the appropriate box: 4. [] I am a general contractor and I F7. e of project(required): 1.[].I am a employer with employees(full and/or part-time).* have hired the sub-contractors ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet Remodeling ship and have no employees These sub-contractors have g• Fj Demolition working forme in any capacity. employees and have workers' [No workers' comp.insurance comp,insurance.$ 9• ❑Building addition 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 insurance required.] t a 152, §1(4), and we have no 12.[]Roof repairs employees. [No workers' 13.❑ Other comp.insurance required.] Any applicant that checks box#1 must also fill out the section below s t howing their workers'compensation policy information. 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-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.#: Expiration Dater 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 a Investigations of the DIA for insurance coverage verification. I do hereby certify er th pains d penalties of perjury that the information provided above is true and correct " Si afore:` ,p "Date: GG�G. y� ©(� Phone#: l/ fit ®/OU 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#: A, �THE rpY,- Town of Barnstable Regulatory Services + r )AENbTAHLE Thomas F. Geller,Director p MASS. 1639. ��� Building Division rfp AAAy A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE:_6C• 1, ?rlt JOB LOCATION:— �p mill/C! G�,i�lfS l�^�r Y�/2 y Ilk number/ street village "HOMEOWNER": .Li(/r�c..S" �� S , �F 47(0 Oleo nloe home phone# work phone# CURRENT MAILING ADDRESS: /U/I Ec�j t7� Gj�.•�// W?4 city/town 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. DEFINITION 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 r 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 inspeotio ocedures and requirements and that he/she will comply with said procedures and require ents �� Signatures Homeown 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 12TO 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 section(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 would 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:homeexempt �1HE Town of Barnstable Regulatory Services ILAtxsT.mt.s, M"gq Thomas F. Geiler,Director Fo may' Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnsta ble.m a.us Office: 508-862-403 8 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 (Address of Job) **Pool fences and alarms are the responsibility p ty of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until a.11 final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date QTORMS:O WNERPERMISSIONPOOLS y ~ �0/ZS/I� Town of Barnstable c V �oFrfu rod *Permit# ti Regulatory Services L Pees6nmnd/r3jrai�lsruednre " HARYSfABLE, y dAss. ,619. Thomas R Geiler, Director Building DivisionX-PRESS PERMIT Tom Perry, CBO, Building Cornrnissioner r r0CT 2 1 ZOI 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 TOWN OF BA{��1�T/�BL Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY .. /Vnl I�nlir!rvrtlrotrl Red X-Press Inrprrnl , Map/parcel Number Property Adressyl��k H d I Residential Value of Work 'Minimum fee of S35,00 for work under$6000.00 Owner's Name & Address r l�I"G( Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance. Check one: ❑ I am a sole proprietor Q. I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accornpany eich 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 #of doors Replacement Windows/doors/sliders. LI-Value (maximum .35) # of window-s--w *Where required: Issuance of this permit does not exempt compliance with other town depa�trnent regulations,i.e. Historic,Conservation,etc. ***Note; Property Owner must sign Property Owner Letter of Permission. eo�j of the Home Improvement Contractors License & Construction Supervisors License is requi ed. SIGNATUIZE: 1V QAWPFILMF0RMS mit r- s1EXPRESS.doc The* C'orwilolrwenlll1 of!' assrrchzlsells -- _ --- Deprrrfinerll of Inditslrial Acciderrxs Of%Ge O,f I17ve'sflb(Jl`lOTls 600 Washrrlgtorr Street Boston, :'fL4 02-111`. t f _ fi�y iuts�rt�.nrnss.got��'rlio - . 'Workers' Compensation Tnsu.rance:Affida-vit Builders/Conti-acto -s,/Electricians/Pl:tunbers Applicant Information / Ple.lse Punt LeQiblN _I'`[at3ie.(Bi>scne�'�Orgauiz®tian•ZndividE�al): tt�/F{.Z;,� L� 9�l?S'' � -Address: a E N 'rta n rzfif�n/t yy City/state/zip,: '&C / 9 0 �3 Ilion 01690 Are you an employer?Check the appropriate boa.: Type ofproject(required), ed); 1...❑.I anz.a ernplo}ter with , 4. ❑ I am a general contractor and I , eaVloyees(full and/oi-part fi e). * have 1tiYed.the sub-contractors 6- ❑Newconstruction ?..❑ I am a sole proprietor orpartnes- listed os2 the attached sheet. 7. ❑Reinodelritg skip.and have no employees These s2rb-cantractors have S. "❑.Demo.lition working :for me in any capacity. employees and have w'orkefs' [No workers comp rMM,rice comp.insurance. 7 9. ❑.Building addition required.] 5• ❑ We are a corparafion ancl.its 10.❑Electrical repaiis oraddi.tions affcers have exeicis.ed their . I am a.homeoi;uer doing.al]cork l l.❑Plumbing repairs or additions myself. [No workers comp. right of exeruption per NTGL 12.0 Roof repairs insurance required.] r c- 152 §1(4), and w.e have no enTloyee.s.'[No workers' ` 13.0 Other comp..insurance.requit-ed.] 'Any appticaut:thatchecls box fl tmstalsn fill out the section lieloa sLotving Iheirtvor7 ers'conrpeyss:ti.on poli.cyinfon=riao t F3onieavnwrs who submit this affidavit indicating they are doing 91 wort and then hue outside•coutraclors mast subanit.a new affidavit indicating suds fConhactnrs that check tL'rs:bmt must attached sn sddi'tiooa[:sheet showing the:nsme offhe sub-emrtrsctws anal stale whether or not"chose entities have" dwployecs. Ifthe subr-c.ontcactors:tiace empivyees,.ihey.must provide their workers'comp.police number. 1 am au gutplcyer that is prgvi4ing iiro.>k rs'sarrr eaisah'rrn irtsr rnrr.ca for levy elirpla�eas.i S loii istlta polir.J and job site irtformatiore Insurance Company hk`atne:. Policy#or..self-ins.Le.t#: Expiration Date " Job Site Address: ' CitpfStater'Zipr Attach a copy of.the ivorkers' compensation policy`decl.are:tion page(shoiidng the policy number and espu•:ation:date). Failure to secure coverage as required utader Section 25A of MGL c.. 152:can lead to the imposition of criusinai 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 viola#or_"Be advised that a copy of this sta.teinent may:be forwarded to the Office of . Investigations of fhe.D.IA for insurance cowrage verifica:tian. 1F do hereby certify-I1rrd �apizbi pennlfies of perjury that the it foi,rtiatiort proygdgd.aboi,e.is true and correct. Si .pure.; Date: �e v,� it Owl Phone#: � F6. 0ther official ttse only'. Do tint wr tg in this area,to be completed by city'or town of ciat or Town: Permit/License# g Authority(circle one): rd of Health 2.Building Department 3, C.ity/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector ct Person: Phone#; Op IHE r EARNSTADLE, MASS,9 Town of Barnstable', . lED MP'I A Regulatory Services Thomas F..Geiler, Director Building ]Division Thomas Perry, CBO Building Commissioner, 260 Main Street, Hyannis, MAI0260I : www.town.barnstable.ma.us' Office: 508-862-4038 "` Fax: 508-790-6230 4 Property Owher Must » Coknplet6 and Sign.This'S ctio z If"lJsing A l3uilde I : , as Owner f the subject property, p .. hereby authorize to act on my behalf w. in all matters relative to work authorized'by this bLulding..pe rrut plication for: F (Address of Job) Signature of Owner Date y . Print Name r If Property Owner is applying for permit, please c mplete the Homeowners License Exemption Form on the reverse side. QAWPFILESIFORMSNIilding permit formslEXPRESS.doc t 1 fF* Town of Barnstable Regulatory Services iEkAFISTABLE, Thomas F. Geiler, Director y rasa Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 518-86274038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION "��,,�� Please Print DATE: Oe`Fv°ee,z JOB LOCATION: Ile—_ 0 number street,�Gt1IM5 village // L J Pa B1 "FIOMEOWNER•" +� s P' 'Y ��0 O(©t e home phone N work phone N CARENTMAILNGADDRESS: � I�ji;�Ll GGZ�Id�� lam_ city/town state zip code 1 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. DEFINITION 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 Aorquilding i "m s-and that he/she will comply with said procedures and requirements. ' Approval Official r" 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 section(Section 109.1.1 -Licensing ofconstmction 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 cannotproceed against the unlicensed person as it would 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 I amend and adopt such a form/certification for use in your community. Q:IWPFILESIP0RMSIb61ding permit fom7slEXPRESS.doc Revised 072110 TOWN OF.BARNSTABLE BUILDING PERMIT APPLICATION,,. Map- P , arceI., 2Applicatidh Health Division Date Issued t Conservation Division Application Fee Planning Dept: Perrhit Fee" Date Definitive'Plan Approved by Planning Board Historic OKH Preservation Hyannis Project Street Address 1AIV5 Village Owner 7zlzla� - 1//</V> ,/--:-Z- wne Address Telephone Ll Permit Request e C-k A, /r"e/e 0-7 'ov 0Z Square feet: 1 st floor: existing proposed 2nd floor: existing Proposed Total new Z6ning District:— Flood Plain Groundwater Overlay Project Valuation 0 Construction Type ArStw�24-t{Zo","Y e_5 Lot Size Grandfathered: LJ Yes b/No If yes, attach supporting �aZcuriAntati6n`. Dwelling Type: Single Family Two Family L3 Multi-Family(# units) Age of Existing Structure Historic House: LJ Yes C9 No On Old King's hway:--tl Yes No' Basement Type: Lei LJ Crawl L3 Walkout Ll Other Basement Finished Area(sq.ft.) Vo K 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 -57 -new First Floor Room Count Heat Type and Fuel: Ll Gas LJ Oil 0 Electric LJ Other Central Air: U Yes VNo Fireplaces: Existing r New Existing wood/coal stove: L]Yes r (No Detached garage:19'e2sting Unew size—Pool: LJ existing Unew size Barn: Llexisting Unew size Attached garage: existing Unew size —Shed: Ll existing LJ new size Other: Zoning Board of Appeals Authorization El Appeal # Recorded Ll Commercial LJ Yes �(No If yes, site plan review# Current Use -Ale-1A L,/I _-Proposed,Use 4-t L'.-O-a APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name I-11VA'i; 26EIZ 7' ZA51<A Telephone Number Address`7` 7 7 4/ tl�SI_LO - License# C5 z 2 Home improvement Contractor Worker's Compensation # we 74zg�/7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /��/ yL; FOR OFFICIAL USE ONLY APPLICATION# r .DATE ISSUED. MAP/PARCEL NO. ADDRESS VILLAGE OWNER s - c , j DATE OF INSPECTION: a FOUNDATION 9s G Cb�zo� FRAME i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL `> GAS: ROUGH FINAL F FINAL BUILDING ,r { DATE CLOSED OUT ASSOCIATION PLAN NO. a ,0 To`n of Bat- astable f Regulatory Sengces v M ss& Thomas F. Geiler, Director. x6Sp ATFb �a - Building Division Tom ferry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnsta ble.ma.us Office. 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign TJ-ds Section If Using A Builder I k �tk I' �-! S. as Owner of the subject property hereby authorize < �� e v v\. t o" to act on my behalf, i_u all matters relative to work authorized by this building permit application for: (Address of Jo ) S ahire of Owner ate xint Name If Property Owner is applying-for permit please complete the Homeowners License Exemption Form on th'e reverse side. Town of Barnstable " N�of YHe Regulatory Services " Thomas F. Geiler,Director sttirrsrws[.i:. _ Bull ing' p1y1SXon PTFD^�'ya Tom Perry,Building Commissioner 200 Main Street; Hyannis, MA 02601 vi i .town.barnstable.ma.us -face: 508-862-4038 Fax: 508-790-6230 HOMEOFT'ER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number 4ticet village "HOMEOWNER": work phone# name home phone# CURRENT MAILING ADDRESS: city/town state ap 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. DEFINITION OF IIOMEOWNER 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 deched structures accessory to such use and/or farm structures. A person who constructs more thanta 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 heJshe shall be responsible foz 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. Th'e 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. ,ignaturc of Homcowncr .pproval of Building Official Note: •Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the tate Building Code Section 127.0 Construction Control. HOMEOWNERIS EXEMPTION The Code states that "Any homeowner performing work for which a building permit is rcquircd shall be exempt from the provisions ,] -Lier�sing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such this section (Section 109.1 irk,that such HOmCOWner shall act as supervisor." Many homeowners who use this exemption aic unaware that they arc assuming thc rtsponsibilitics of e supervisor(see Appa�dix Q, Ors&Regulations for Licensing Constructian Supervisors,Section 2.15) This lack of awarcncss often rrsults in serious problems,particularly =the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would xrith a licrnsed pervisor. The homeowner acting as Supa-visor is ultimately responsible. To ensure that the homeowner is fully awasc of his/hrs responsibilities,many communities rcquirc,as part of the permit application, .1 the homrowner certify that hdshe tmderstands the rtspOnnbilities of a Supervisor. On thc last page of this issue is a fort currently used by ,cral towns. You may cart t amend and adopt such a for✓certification for use in your community. • I TlzerCornrnompociZth of Masscuhicsezrs ' ,Department of lndustriaf Accidents Office of Envestigatiotzs 600 WashznVor, Street ,Boston, MA 02111 • rvww.rrr-ass.gov/dia • Workers' Comp eusadoi Ingaraance Affidavit: Builders/Contractors[Electricialzs/Fluiabers Applicant Lnformationut ��k S Please PrintLe�zblY Nae (Business/Dr�j7afidn/Individual),. � L C. (. Oft ,Q#A/y Ad-dress: ' '7l�Sn L aG✓ /Q�Y /� /� City/State/Zip: =Y i�/'' 0a77� Z�'T �°� 3� Are you an eraploycC Check the appropx`iate box. 'Type of project(required): 4. ❑ I am a general contractor and I 1.❑ I am a employer with 6. ❑l�cw construction i employees (frill and/or part.ti-mc).* have Iuzed the nA3-contractors �. Remodeling 2 I am a sole proprietor or partner- listcd°p the attached shact ❑ ship and have no eraployccs These sub-contractors bavc g. ❑ Demolition. eroployecs and have workers' working for me za any capacity. 4. ❑Building addition [No workers' c6mp.-mm ancc Comp. ,neL]1�IlGC. 5. ❑ We am a corporation and its 10_❑Electrical repairs or additions rc quxrcd] officers have exercised thcir 11.[�Plumbing repairs or additions 3.❑ i am a hDmcowncr doing all work myself [No workers' comp_ right of exemption per MGL 12 ❑RDofrepairs_ incr,r ncc rccluizrd_] fi c. 152, §1(4), and we havt no employees. [No workers, 13.0 Other comp.insurance rcgi iced] *Any applicant alai chccl5 bcx#1 runrt also fM out the t=6on bc1OW showing thcu workcza'compcnsarion policy information_ t Hommv,mcrc who gubrmt ahis efdavit indicating tbcy arc doingia work az,d the,hire outside contractors must subrmt anew affidavit indicating such_ $Coz,lraetars that ebeckthis box must attanc�d an sjditional sheet tbowing the name of the sub- o t-art az,d stair;whetlher or not thosr entities have crnployecs. 1f the subconiraetans have rn,ployc=,tbey must prvvidt their vrorkrrs'comp.policy number. ,I am an employer that is providing workers'ccmpcnsahoa insurance for my employees BetoI-v is the policy and job site ' [nfo rrrtalio tt_ �j1 f� Insnuancc Company Name: Policy#or Sclf-ins. Lic. #: [ �( / ExpizationDate: Q�`f3(�� Job Site Address: �� �L/ S CIL©S L/V' _ City/SaEe/Zip: [' '" GI��/LLL� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverago as rcquirr under Scctiou 25A of MGL c. 152 can lead to the imposition of criminal penalties of a 5-ac tip to 51,500.00 and/or one-year imprison=nt, as well as civil penalties in the form of a STOP WORK ORDER.and a fine of up to 5250.00 a day against the violator. Bo advised tilat a copy of this statcmerit may be forwarded to rho Office of InYCSti ations of the DIA for ine„rancc covcra e Yerificatiom I do hereby certify der the pams•and pc:naW,--s of perjury th.a1 the information provided above%s true artd correct Datc,: 1 � D� Si a_ttz<e: — Phone ronly. Do not write in this area, tb ecompleted by city or town awn: Perm.it/Licensethority (circle one); I. Board of Health 2.Building Department 3. City(Town Clerk 4-Electrical Lnspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Massachusetts General Laws chapter 152 requires all erirployers to provide workers' compensation for their cmployecs: pursuant to this statute, an employee is dcfincd as "._.every personcr in the svicc of another under any contract of hire, I express or implied, oral or written." Au employer is defined as "an ipdividual, partnership, association, corporation or other legal cntity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a dcccascd employer, or the receiver or trustee ofan.individual,partnership, association or other legal entity, employing employccs. HDWCYer the owner of a dwelling hour c having not more than thrcc apartments and who residcs therein, or the occupant of the iwclling house of.anothrx who employs persons to do maintenance,construction or repair work on such dwelling house )r on the grounds or building appurtenant.thcreto shall not because of such employment be dremed to be an employer." vIGL chapter I52, §25C(� also states that"every state or local licensing agency shall pvitlrbole3 the issuance or •enewal of a license or permit to operate a business or to construct buildings in the commonwealth for any Lpplicant who has not produced-acceptable evidence of compliance With the insuraa �co Ve,ag requ reds'" �Clditionally,MGL ohapter 152,,§25C(') stairs`Neither the commonwealth nor any of its political subdivisions shall :nter into any contract for.the periormaucc of public work until acceptable cvidenee of compliance A-ith.the io--m-Amce cquircmcnts of this chapter have bccn presented to the contracting authority. ,pplicants lease fill out the workers' compensation affidavit eompletcly, by checking the boxes that apply to.your situation and, it of rc up essary,sply sub-caniraztor(s)name(s), address(cs) and phone numbers) along with their certificates)th er than the mira-ncc. Limited Liability Companies(LLC) or Limited LiabilityPartncrships(LI2)with no craployces oth Lcmbers or partnct-s, arc not required to carry workers' compensation insurance. If an LLC or LL.P does have mployecs, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial ccidcnts for confirmation of insorancr coverage. Also be cure to sign and date the affidaviL The a$davit should returned to the city or town that the application for the permit or license is being requested, not the Department of idushial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' impcns&6on policy,please call the Department at the number listed below. Sclf-insured companies should mtrr tlacir lf-incttiranGb license number on the appropriate line% ity or Towp Officials case be sure that tbo affidavit is complete and printed legibly. The Department has provided a space at the bottom 'the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant case be surd to 511 in the permitlliccnse number which will , used as a reference number_ In addition, an applicant it must submit multiplo permit/license applications in any given year, need only submit onp affidavit indicating c=cat l cy inf6rm&6on(ifnrccssary) and under`Job Site Address" the applicant should write"all locations in (city or fin)."A copy of the aft davit that has bccn officially stampr-dd dr.marked by the city or town may be provided to the plicant as proof that a valid affidavit is on file for fature permits or licenses. A new affidavi4 must be filled out each ar.Whcre a home owner or citizen is obtaining a license or permit not related fo any business or connncrcial venture a dog license or pmTait to bum leaves etc.) said persora is NOT required to complete this affidavit e Office of lnvcstigations would hkr to thank you in advance for your cooperation and should you have any questions, a.sc do not hcsiiatc to give us a call pCpartmmt's address, trlcphonc-and fax number. Tha C6=mwe9th of Massachus(-,M Dcparbnent of Iadustdal AC-CidQnts EQfcc of luvestigatto-ns 600 washingtaa Street Boston, MA 02111 Tel. # 617-727--4M.0 ext 4-06 ar. I-S77-MASSAFB Fax # 617-727--77491 i 11-22-06 VrVW.maSS.gov/dia - ,per ✓fze Toazroz�ao�a�ueczC� o�./Glaaaczclzuaet�`a \ License or registration valid for individul use only Board of Building.Regulations and Standards HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board.of Building Regulations and Standards Reglstraiio& 152372 One Ashburton Place Rin 1301 Expiration 8/23/2008 Boston,Ma.02108 'Type DBA BALTIC COMPANY LINAS REVINSKAS , 166 UPPER COUNTY RD;1-11 Not valid without signature DENNISPORT, MA 02639 Deputy Administrator MONEYGRAM PAYMENT SYSTEMS,INC.DRAWER 1 - P.O.BOX 9476 - - N PLEASE READ REVERSE 5/DE MW NEA OOeIS,MN 55480 _ _p - - ygram.com DATE/AMOUNT � aim . o BOARD / •, 3Ck;> o Licens CO OF BUILD L a'tl it? r , • • 1 i o< . STRUC O GULATIONS �o�� TI :L tl' Ot.t W<� Number CS N SUPERVISOR . O� t?1.1i 1t ?t, UUii ooso i Brrthdate 10/02/lg 7 94476 rz 7 � x, �W , li 6 p res 10/02/2009 Q c /] Rest r Tr-no; R. 1 v U`F H O i LINAS REVINS f cted j 00 94476 ` 1, O 1 5 3® EMPLOYEE W . .. 166 UPP KAS °� 7rs(vo7)Too/ia000 M 92579-P DENNIS O COUNTy`RpA4 DETACH HERE - f I PORT Ib►q 02639 �... Cornmissiorier ,. Licensee Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPS) Public Safety . Mass.Gov Home DPS Home EOPSS Home Mass.Gov Home State Agencies State Online Services Department of Public Safety Licensee Complaints License Type Home Improvement Contractor License# 152372 Restriction Company Baltic Company Name Linas Revinskas Address 447 Winslow Gray Rd City, State, Zip S Yarmouth, MA, 02664 Expiration Date 8/23/2010 Status Current No complaints iOUnd for this Licensee. Back TO.Search http://db.state.ma.us/dps/licdetails.asp?txtSearchLN=HIC 152372 9/22/2008 Ul � K >1 J d Existing building New door CL. < ,ln S CA4 2 CA4 1 I -� L F-1 L J -}-� :3 `D (1) L1-) U U W Q Scale NO CA4>2 CA4 1 New deck Date: 26 09/02/08 62'6" Drawn loy: i Baltic Co SOUTH ELEVATION ; - Al C►' � - Existing foundation --i d n - Q U1 S d U � S J d > :5 W P o New concrete -� Ln v �--+ footings 6 6" 0-C o o W 25'9" S� �� Scate NO Date., 08/19/08 Drawn by, Baltic Co Foundation plan A2 Existing building U) Ln J - d CL Q d U y J d > M a, Li J � LtJ 4-1 1 -, � 2x10 Preasure in u 2 treated joist 16' ❑C 0J U W Q 1 Scale NO 3 4 26 Date- 09/02/08 1. Metal angle connector 3. Post foot Drawn by. 2. Typical joist connectors 4. Post cap connector Baltic Co DECK FRAME PLAN A3 3 Ln Section 1 Section 2 -jLn ti - d Ln 4x4 PT railing post Existing fastened with lag Ln d U 7 bolts to the deck f rame -' J d > Li -N 1x6 composite C decking, --� LO U New 2pcs 2x10 1x10 PVC trim with Y2' spacer header 4x4 PT post Typical t cap high depenos ds on Ponnector U �D grade elevation Li Q `D RO 6' x 6'6N Post foot with anchor bolt 8" f ooting d- Scale N❑ Bigf oot 21" Date: 08/19/08 New Drawn by: Existing Baltic Co Sections A4 4 Am(04 ,� •fit�.�d ta'tt.Ow" � 1 h 1 -� -M r; t� ?�`a?�•:St�. .+ .. =3oJ EEC S eS;P.�D ' 111 7 a t y� Pos, 1 . .P " �!•'�_6r�•t"b✓�'6 `ber G.� o �y ` N� ..r. p{ :'Foul 4 {?'D, 1 t) R 4 Sl` l �• ,� t{ , r pi g + vrwr_ >L T10tJ •. 1 r: , ; -t ; +. it }r d +-}i#�:F a �j st + 9.i -!� ! { I 3 t , ��. - 1 � j -.i {. , t. , a <•..4 { t. » t ,s S � fi� r,tt ft r. } { 2 � �t - i � i - 4T tl' 1 f y -�•.-��.� ,{ �< y w .v+Mi.an+.^ . aaynma«� 1,•y+e,r j Y-JF� ^�3.�'- 'tl T .t �.�y.�t"' ij--4 {. x - •`..!^.} ' - .� a t d i .� ;{ p 'I. i .} S�.jkt_ 'xG.3'� dr..at 'S tii s ii , •s.s i t i- r t t � ..{�..� �. -e•, �� .{ 3 - ,ss{{° �" tt i It••!i aj{4�} ! -r!p!-r;x i.�wr � 4'j, 7 -t�r �' � - };�t { � . r; .J a. 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I r � •"t � # ' f .. , .. :�o 'C+ .......�3.. .. ,.r33" �� 4 }+i .�.L.11i'{.._ ry 33 i' .ws. Of. �Osi .� -- .�. ''tZo "t ���A;� G i .IPA c( 4 i . �P � C F .; . �.� 7 , 3 it � x3 r -."::*� { t. y .s{. t q ,..{ 1! ir•^ MOIR o &»d 0 'C' A4.lt� 5C"Cu"t&:tw.FA; t �'� ' L..®GATEb" VJt'1�-•lttl,- •'�° �'t�.o�vt� t�.•.t � } �•� t „--� ..{. .- + -. 021 .._. - �. c -• • i2�G 1�a�CZ�b""'.1::J�"6•-t t;,:J . _.SU���=-` UOT Ar�AS�a• t 1rt'Ct,Jra/tiC;�.t t ;US..rI:Y �• Yt�c;. v�'r~,�-:C'r, �taGwt.:x> AkaPt_I C.A,t-1_r �, �LL a. L•.r n.t^: r.1;[.L'7 '�u l7�tGC:.h,�1►•jl-e. `C" `l_1N� °s �'� - °l ,(,rA - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION J Map. . Parcel v1 Application , Health-,Division f Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic OKH Preservation / Hyannis i Project Street Address /V' Village Owner Address 6 Telephone �wT� V/,`L � ' �� Permit Request �o r� 0'+ �� �u c K Glenn G( '� r� Aq e /S / _ r Square feet: 1 st floor: existing proposed 2nd floor:,existing proposed ) Total new ' Zoning District Flood Plain Groundwater Overlay `- Project Valuation 5 3 00 Construction Type - , Lot Size Grandfathered: 0 Yes 19 No If yes, attach jsup, orting dcumentation. Dwelling Type: Single Family L� Two Family ❑ Multi-Family(# units)Age of Existing Structure ?-.� Historic House: ❑Yes dNo On Old KinghwgLp❑Yes ❑ No r,l Basement Type: t Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing Z- new Half: existing new Number of Bedrooms: 2_ existing _new Total Room Count (not including baths): existing � new �� First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil L Electric ❑ Other Central Air: ❑Yes �No Fireplaces: Existing V New Existing wood/coal stove: ❑Yes &6% Detached garage: �❑Jexisting ❑ 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- -�e S c o c.� c�._ c -= - ---- Proposed Use` -- APPLICANT INFORMATION �^ (BUILDER OR HOMEOWNER) Name ` j �G Vi �� �� Telephone Number Address / U1116L&W Goehy Q I) • License # Cs 09 y r7 6 02 GG y Home Improvement Contractor# Worker's Compensation # V/t ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �� �`� SIGNATURE �'`�`7 d�� DATE 4 1LIZ Q f. FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED Q MAP/PARCEL N0. ADDRESS VILLAGE OWNER ` y DATE OF INSPECTION: 7 FOUNDATION FRAME S . INSULATION FIREPLACE ,y ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING µ Y DATE CLOSED OUT , ASSOCIATION PLAN NO. I i t• J T1te Coritrnonwearth of Massachusetts Department of Industrial Accidents. Office of Investigati.on.s 600 WashinVon Street Boston, MA 02111 www.mass.govldia Workers' Compensation Tnsn-rance-A.ffida-v t: Build ers/Contractors[ElectriEciansfPlumberg ,kpp'licant Information Please Print Legibly Nagle (Business/Organization/Individual):Z—IAYS /1P,Ck/ k tq S 054 13AL , IC C'OM r,Ny a i !� r7 �A/l/I�SL tJ L✓ /2 ft /* /�• L'1LLLL1 lJ J.7 City/State/Zip: S- / /e/`�0�.1'I'(r HA 0216thone.#: 11d?1 -2 d''7- l.7 3 rl 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 1 6. ❑New construction employees (full and/orpart-time).* have hired the s`tib-contractors ,.,{ listed on the attached sheet. 7. Fy Remodeling 2. 1 1 am a`sole proprietor or partner- ship and have no employees These sub-contractors have g, ❑Demolition working for me employees and have workers'in any capacity. 9. ❑Building addition [No workers' comp. insurance comp.uisura-nce.f 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ required.]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 1 insurance required.] t C. 152, §es. [ and we have no 13.V-Other QeC L cosni�( ►� employees. [No workers' comp.insurance required_] Any applicant that checks box#1 must also fill out the section below shovring their workers'compensation policy infornmbon. 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 subcontractors and state whether or not those entities have employees. If the sub-contmaors.have employees,they must pro-vi&their workers'comp.policy number. I am an employer that is providing workers'compensatiDn insurance for my employees. Below is the policy and job site information. t Insurance Company Name: 5 Policy#or Self ins. Lic. Expiration Date: Job Site Address: EL /�/1`!1 G,C11 CL`�T� 1z-�5 L N' City/State/Zip: 9 V/LLC M 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 statcmerit may be forwarded to the Office of Investigations of the DIA for insurance coverage verification: I do hereby certify tinder the pains-and penalties of perjury that the information provided above is true and correct.. Signature: ���� /� �� Date: .Phone 4: ���` Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/Licensc# Issuing Authority(circle one): L:I3oard of Health 2.Building Department 3, Crty/Towri Clerk 4.I;lectrt'cal Inspector 5. Plumbing Ins p"ector 6. Other Contact Person: Phone it: �P Massachusetts General Laws chapter 152 requires all cmployers to provide workers' compensation for their employees: servic.e of another under any contract of hire, to an employee ee is defined as ... .Pursuant to this state p y every Person in the 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 liceusing 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 cvideace of complizDcc vhth 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(cs) and phone numbers) along with their ccrtificate(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 affidaviL 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 obtadn a workers' Compensation policy,please call the Department at the nurrtber listed below. Self-insured companies should enter their self-insurance license number on the a2propriate line. City or Tow}r Officials s Please be sort that the affidavit is complete and printed legibly. The D epartment has provided a pace 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 permil/hcensc number which will be used as a reference number. In addition, an applicant c applications in an given ear,need only submit one affidavit indicating current e 't/7iceus a Y that must submit multi le mu pp Y� Y P P 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 (Le. 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 calk The Department's address,telcphone-and fax number: Thtt Comm.ozwie4th of Massach=tCs Dt,put-nent of ludust.al Mcid=ts Office of ba-Vestipt ous 600 Washington Street $QstQn, MA 02111 Tcl. # 617-727-4900 ext 406 or 1-M-MASSAFE Fax## 617-727-774 Revised 11-22-06 www.maSS.gov/dia Otto. HE �L Town of Barnstable Regulatory Services r BAMNSTAAB1 - Thomas F.Geiler, Director MAn �iv�a�$ Building Division Tom Perry, Building Commissioner F 200 Main Street, Hyannis,:MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-'6230 .± Property Q*ner Must' 'Complete and Sign This Section If Using .A.Builder - L� „as Owner of the subject propertyr hereby authorize `� �u 5 �. c to act on my behalf, in all.matters relative to work authorized by this building permit application for: (Address ofrob):. sigriature of Own89 Date 6 HU P t Name , -If Property Owner is .applying for permit please complete the:Homeowners.License Exemption Form:on the reverse side. ... a * ` f .• .. s 9 �. - Town of Barnstable of 1HE Tpy Regulatory Services t Thomas F.Geiler,Director sAxrtsTAK9. MAS& Building Division PTfD '� Tom Perry,Building Conurrissioner . 200 Main Street, Hyannis,MA 02601 www.town.barnsiable.ma.us Office: S08-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER"". name home phone# work phone# CURRENT MAILING ADDRESS: city/town 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. DEFINITION 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. - a period shall not be considered a homeowne r. Such a two e r person wh o constructs more than one home m y p P . "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 section(Section lo9.1,1-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 resporsibilities of a supervisor(sec 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 would 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. Page 2 of 2 r __ __._.. . 1 Select a License Type!S elect One Search by Last Name First 1 Search by City Zip Code ------- Search Search Results LICENSE TYPE BUSINESS CONTACT LICENSE RESTRICTION ADDRESS STATUS NAME NAME Home Improvement F ? 166 Upper County Rd 1-11 Dennisport, MA' Current Battic Company • Revinskas, Linas 15.2.372 r Contractor � 02639 file://C:\DOCUME-1\permit\LOCALS-1\Temp\R6ATR7UG.htm 8/27/2008 s �/ie oom�nO ' REC'vs. BUILDN SUP Li ERVISOR BOARD OF i; ONSTRUCTION i cense 094476 CS t t �?; 10102�1�977 g4476 girthdate Tr.no: 1 LLx ires' 10102�?009 .i I R ii 00 'es�tncte } 4 / I REVIN166 UPPER S►�Sk3D LINAS COUNTY 639 Commissioner DENNIS PORT, MA �2 I ✓�ie C�Ja7n�rea7uuPa o� e1�6 I Board of Building Regulations and Standards License or registration valid for individul use only HOME IMRROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards > Registration: 152372 One Ashburton Place Rm 1301 Expirat i 66':-�-i&23/2008 Boston,Ma.02108. � v� k �Type DBA BALTIC COMPANY t LINAS REVINSKA`S2 166 UPPER COUNTI RD �.� Not valid without signature DENNISPORT,MA 02639 Deputy Administrator a �, I In i d Existing building New door CL Q � S d U Q� —1 d > CA4 2 CA4 1 Fr > W -I' C Ln U 1EJ Lj U L►J Q Scale NO CA4 2 CA4 1 New deck Date; 16 08/19/08 6216" Drawn byl Baltic Co SOUTH ELEVATION U Al Existing f ounclation —� d Ln Q Q LA d CD Q� Y � S —J d > _:3 LLJ 4--*, o New concrete :3 � U Cu f ootings 4,6„ o 0 o W 15'9" Scale NO Date: 08/19/08 Drawn by: Baltic Co Foundation plan A2 Existing building -j d Q -�_ Q J d > LJ -i•' 1 � � 2x10 Preasure Ln U 2 treated joist 16' OC o U W Scale NO 3 4 16 Date- 08/19/08 1, Metal angle connector 3. Post f oot Drawn by; 2, Typical joist connectors 4. Post cap connector Battic Co n DECK FRAME PLAN A3 . Section 1 Section 2 W J 4x4 PT railing posh Existing f ast.ened with lag Ut s 7 _ bolts to the deck U f rame 6 > 1x6 compos-ite - decking � � Ln u New 2pcs 2x10 1x10 PVC trim --- with Y2, space"r, header Typical 4x4 PT 4post post ca high clepends on p U.- `0 grade elevation connector i "o q RO 6 x 6'6" Post foot with anchor . bolt 8" footing Scale NO Big f oot 21" Date 08/19/08 New. Drawn by. Existing Baltic Co Sections A4 4 r jr,4lip t r �n �a'At276C:tAG� �►Q4 i.IGSZ. .}f t 4-�! 1='!.t>u✓ t 1b +� 3 4. �39 p �.p t� i a� d 1 rf , �'� .�� 'Z;IG 'T`�,1C �:. ��©v lr7C oi".r«;m �ra.iS.P.D: j •. r �-.,I ,. �� � r.,. {.� �� •. (l/ (cp t , TOTA L.17.G51G►J �5'L5 G p .. 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' ♦r. r^ �{� �I r i 1 � + t �; .ti�,,_.� . � ..�. err + ,p ;1�1 --" � v 7i • . `'-8 ° jW./1 tOGD .4 t. ^1fY1-i-"EH �' .+3 I •./,� -i' :r• t,,.,;, a Az7D3'ti1N �' � M 1 �: Ir. , fit', •, + ' t �. � F wasi s lye 1ZT _'_ _ .-' -_� :. Y I: _.:..:.!i-� 'vim_?_ i 4 i•~ �._ � ',•.' y �� haili.r. J I 1 1 i + t C.M a•CT1 .....,..'Y P1/\ /"•,: -F"kG1^'7:1ta1"�LCCr^S.. ' r+'t r t=C".�.. .. ; T i r t � L..00AT tb• W ITVA1 4 � •`t` G(.oc�t� Ex.-!�1{.I ,. f ft• _.i , I, . a-rF_ , - c _ S AXAS� T 1-1 t . . tc t (' LJ.uG�1JZ' ��vt�.it-�{ • �(r1c�. c��c . C'. �ttowt� APPL-1 n.r.. i1>Gn fu t7�rC�kttt.l —. lt��f' ' l.lNca.5CA1� G � QtL I � . I UNITED$TRM� ;O&T'� OvIA,i ��:�: � .. � a9��.,� 6 .- "'Rfl7f►°�"y. t�ge less aid aw I I • Sender: Please print your name, address, and ZIP+4 in this box • I ! I 'DOWN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. j HYANNIS,MA 02601 I I SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature Item 4 if Restricted Delivery Is desired. X � Z ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. R by(Printed N C. Date of Delivery ■ Attach this card to the back of the mailpiece, AMD " 7 or on the front if space permits. D. Is d liv address differen item 1? ❑Yes 1. Article Addressed to: t: S If Y e r delivery a below: ❑No L`we- 3. Se Type arbatified Mail ❑i; +ess Mail ❑Registered (R'Retum Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) - ❑Yes 2. Article Number ••-- ' i z z7006 i 081`01,0 00 =35'21t 8-717 ` (Transfer from service label) PS Form 3811,February 2004 Domestic Return Receipt 102595-02-10=54g i r� III `Y Ln M Postage. $ $0.42 0672 i . O p Certifled Fee $W o70 01 C3 Return Receipt Pee ry 5 P Hstme rk (Endorsement Required) g, O Restricted Delivery Feed d�G r-I (Endorsement Required) cD C3 Total Postage&Fees $ $5.32 08i 25%2008 -0 O Sent To C3 [�- .... a. .................................. Street Apt No ` �� �� or PO Box No. City,Sta IP+4 . Certified Mail Provides: n A mailing receipt il—wb)zooz eunp•ooee w,oj ad ,o A unique identifier for your maiipiece ` o A record of delivery kept by the Postal Service fof two year ' Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. a Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of. delivery.To obtain Return Receipt service,please complete and attach a Return. Receipt(PS Form 38111 to the article and add applicable postage to cover the fee.Endorse mailpiece Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. A For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the.Certffied Mail receipt is not needed,detach and affix label with postage and mail: IMPORTANT:Save this receipt and present it when making an inquiry. Internet access.to delivery information.is not available on mail addressed to AM and Ms. Town of Barnstable Regulatory Services pUt �qy Thomas F.Geiler,Director Building Division BnaxsTnBLE, : Tom Perry,Building Commissioner 9 MASS. 039. 200 Main Street, Hyannis,MA 02601 RFD MA'i a Office: 508-862-4038 Fax: 508-790-6230 Notice of Zoning Ordinances Violation(s) and Order to Cease, Desist and Abate: Tadas Stukas & Julius Lukas Pasys & Laura Palaimaite and all persons having notice of this order. As owner/occupant of the premises/structure located aL,5`6 Elij:ah=Childs La -enterville Map 171 Parcel 254,you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORDERED this date,August 21, 2008 to: 1. CEASE AND DESIST IMMEDIATELY,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: Violation of Town of Barnstable Zoning Ordinances: Chapter 240 Section 13 (A) 1 RC Residential Zone 2. COMMENCE immediately,action to abate this violation. SUMMARY OF ACTION TO ABATE: Automotive repair and/or storage and sales of automobiles at 56 Elijah Childs Lane, Centerville. And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the Town Clerk of Barnstable,a Notice of Appeal(specifying the ground thereof) within thirty(30)days of the receipt of this order(in accordance with Chapter 40A Section 15 of the Massachusetts General Laws). If,at the expiration of the time allowed,action to abate this violation has not commenced,further action as the law requires will be taken. rder, Robin c Giangregorio Zoning Enforcement Officer Q/FORMS/viozonel Tovin of Barnstable. Building Dept. 200 Main Street Hyan is, Ma 02601 Julius Lukas Pasys 2 Windy Way Unit 224 Nantucket Ma 02554 1 w EJ YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost$30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall). DATE: ®l 2 2- 0 7 Fill in please: APPLICANT'S YOUR NAME: Tot d a.S 1-5/u k cz s BUSINESS YOUR HOME ADDRESS: 5-6 166,p-t-) �e9cl—r co-) 5"0f,420-0362 C2 n fr r el-e � 11�'.c( 6 26 2 TELEPHONE # Hom e Telephone -- �- Number: U�S 2® od G2 ,................n............_. e vt cR o r. ...�.,r, t ,......1......_..._........,...,....!,....._y.k....._.:........:.,.....!,r�:...�x......::..—......'..r.ii.,:...:I:.�.,!..._.._,_rA.:,._:,:a_.:_._.._......in.a:...:.,..-._.._,�..r..y,.!1��).6 lr1lln...r..rJr.r..d.Y-......rH.:If,1...1..,r.:1 r!A.,..::..I......,.b......an....5..r,.,�..._r,..a.,,...r,_:r,:.v._:M.s.l,r..,.',r ri r,........._..............................r......r...,....._...._.........,....H..__„.:.,r...r...,.,,.d,.,r.r,..P,..r�.er......_.._a..v:..•..r.,.r._......_,....,.,..,:,....,........_._...,_...,...,...,.._.,....._...,J.,..•.....__.......,...........:.h....!.v.....1..n.a.....,!........,...1.,.r.,.......,.,.........,_......_.b.r..,..............ra,rL.n..,,,..x,.L r,...{.r..,.am.._........+.r1..r.r..,.__,....,.n 1.ln....1..n....v...n.__.......,.....,.!...r,.,.'IJ,,..nr,.r_1J a_..n..:.i..,f.....!.._.!.,.r».,..I ro.n.,..n.F_._.er!....,......r..,,m..r........vr....r,..S,..s,.a.u,,...:�.9,.....__v...._....L..x.....!.,u.....6v�,r.....,.,,...._.::_,r,..P.,J,1...r...m:!n.,.,._.;n.,.,....J.v..r....l...r�,,....:..v.,........r_....._i_......u!...v,...I.,,._...,......_..r,:.r,..r..n......�,i_.l....r......r..._rr..+I...L..v,I!r...r..m,.!.!,hv...,.,4..ra.,.n.v.-,h,,.Lu,r.v,,a.:.„,..a.,.v.,,r{l.L.ax,r._......___.,....,.......I...a...e.._.3,_L...f......n._v.t.'.v__,._.....r d,.n_x.... .,._,..✓l.ir......I...:,r„.:r.__�_..:.,.1..,r..:.__n...C.,....9.._.......,.._x5n..l,..r..,.!,.,n.:.Ius.:..:....._;...r. :! !... .riL::5l,n'n- 1.!.:.cn�.l;h:,•!....1 1t: n!....:3 ...5...ri!tn..i..l r,.,..,.Ir,,,..,:r..•_,.,..,.,.r.,J.r... r.r»„.!..x_.r....._,...._.,.r,..,.. ..,.. ._hn::,:,.:.rr....!... ..... ...... .....r ICI'!'_,........a�.,. �{':u..l... .._..rT•T.,,...rr�.:"! r:,'...��.....�r'f.( .. 6 .n.._, .,...._:x:!Fr.a:!'v4::c,!,.r4n,.},xn{..:.....L._.v.. __!�..,.._ - .11..,..@.. ! .. , ,, ... ...IL r,�r,!.Y ,. ,n., h._r.w!.. ... .... .....li.. ...: L..TIv..I. hf.... ..}.,. ._Lt fi»• -�,y ,..,,».fir,.:,,.,,! .,_ _.. n.r.,. ,tr..........r.............. :,.�:._..:::.,rn:.::t•:,.,i..,...r...r:..h,!,..,a.r,:,�:::n.:::.n,.::,;:r..,!_..; .I 9 Ir ,._d..n,.r.b. :.: ...,.r.,,Il f ,.P v.. ..n,. ..,.=:::n:nu.!,:�.:!:: .:. ... ._r.,.. r.............•....r.,...,.........r..._n............, ..r:n,:_m,.,_, .... .. .. S,. ..... ,�,. !.:... ... ..»na.,. .. _.r._....1,._. ..... ..I •,.P.!... -,..1..,,L,.!�.........!..a.h _.r......a.!.._..n.r.....,..,..rt .1......r.....r..._!r...r..... ..r ...r...,..... .,.t4..n.,.r .,,.,.,. •r, ._ i...,...,, n. .... .._.......:................ .. ,.,,..,.._!.L.....I..,. _. ...._.,.._,.....,...., ,,:,,.9...._.,.l..r,_. ,,..r!,•.[......,..»....r....d.....J,. !!!.t._......rr!,._».n�rrP.,:!!c!( .. ( ». i .. 1 ._.. r, , ...L.. .a � _ ...,.u.n. ....r.rn..r:...a............ ..:.......... ..u:�::::,........,ar._...- - , ...,n _........_..,»..... .......r...r..9._..nl n,l..._.....r.a_.....f..,c:v:a...u........li (.I,1.. ,.... ..,_:,... j „ ., ,...n......a._.,rv.......5.....r Ir... r •. .r.r rv.n .,. .... ...._:... :.. ._.... ...e...y...J'nl!.in.r. vla..!L�:.._.__,..1 .... .L.!1. I...,_.._..... ,..lr(,t.b...r r..r..r... ...t:.+...,f.......................h.,_,..,.I....a,.,r: :url:�. �+ 1. nr,....x...,. .. .. �.r..... ._ .......... .....1 .... �..... .� _. .. _.,. r._e.n......._. rr,.., ,,,.�.,...,_,a,.. „rlr..{...,,..._. .1 r!:1-.,,. , .a. ,.r.....!. ...... ....... �,::.... .,. ..._ ._.. ...,,.....,r.I....n.r...u......,,..:�.,=P!!5.6.........,..,L_...... .,Ir,. `!`C!PMa' A .t .....:. ... ,...:.. r.!..i 1 ...... _..._..... .,........ ..7...._rr ...,.._.._....r....._....,.......r...,.._.__..r._.r.....n =.tt 'may} ...... .. .. ,.. .._... 'i _ When starting a new business there are everal things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO TONER'S OFFICE This indivtual Wg ofor d of any permit requirements that pertain to this type of business. Authorize 1gna ure** COMMENT 1 — a^g ( iQ o l 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature" COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual hen infor` d bf the li ns' r u'rements.that pertain to this type of business. Au,h�pjrized Signature"'" COMMENTS: Town of Barnstable THE 7p Regulatory Services �pF k� P Thomas F.Geiler,Director Building Division _ 1639 ,0g Tom Perry,Building Commissioner AIED�r►'t° 200 Main.Street, Hyannis,MA 02601 •www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Approved: Fee: C?s' ae Permit#: HOME OCCUPATION REGISTRATION Date: C" f-u�u lq I3 %'/cs 6ol� c hrz r;�e� #: S'0<? -- �2 0 -D3 G Phone Z Address: S G f6/�' A Ckz��W-r C,f/) Village: C2 le,, Name mess: 7a- ��S. lG( k a 3 Type /� Map/Lot: T e of Business: S P/'yio C e o�Ca/?[1 �r INTENT: It is the intent of thissi tion�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 groundwater 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 na more-than- 400-square feet o€space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration, smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,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 generated by.such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related 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 exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for�;�—Date:—Q ation I am registering. (� ,( Applicant: `C �' -f v / L(IGQ0�( 1/2 2/d 1 Homeoc.doc Rev.5/30/03 MM DD yyyy ❑Delete _ A 10192O U 10 04 2008 11 108-0002981 000 ❑Change BiRS c sic l FDID * State* Incident Date * Station Incident Number * Exposure * ❑No Activity Check this box to Indicate that the address'foz this incident is provided on the Wildland Fire Census Tract $ Location* Module In Section B "Alternative Location Specification". Use only for Wildland fires. ®street address 56 " IELIJAH CHILDS IN ❑Intersection Number/Milepost Prefix Street or Highway Street Type Suffix [:]:In front of �� [CENTERVILLE I �J 02632 -1 ❑Rear of State Zip code Apt./Suite/Room City p ❑Adjacent to I I ElDirections Cross street or directions, as applicable C Incident Type �k E1 Date & Times Midnight is 0000 E2 Shift & Alarms 911 (Citizen complaint I check boxes if Month Day Year Hr Min Sec Local option dates are the 'Q Incident Type - same as Alarm ALARM always required u u COM1 3 Aid Given or Received* Date. Alarm * 10 . 04 2008 IO8:43:29 D Shift or Alarms District Platoon ARRIVAL required, unless canceled or did not arrive 1 ❑Mutual aid received I IU ❑ Arrival 1 101 1 041 120081 I08:44:14 E3 2 ❑Automatic aid recv. Their FDID Their 3 ❑Mutual aid given State CONTROLLED Optional, Except for wildland fires Special Studies 4 ❑Automatic aid given I I ❑Controlled " " L111 Local option 5 Mother aid given Their LAST UNIT CLEARED, required except for wildland fires �� U Incident Number Last Unit Special Special N ONone L0J L_�4 2 0 0 81 IO9.37: I 27 study ID# Study'Value ❑ Cleared F Actions Taken G1 " Resources * G2 Estimated Dollar Losses & Values Check this box and skip this LOSSES: Required for all fires if known. Optional section if an Apparatus or Personnel form is used. for non fires. None ri (Information, I $1 1 L-J L0001 ❑ Apparatus' Personnel property 000 `, 000 Primary Action Taken (1) Suppression ' I I I �—� contents $1 000 000 ❑ Additional Action Taken (2) EMS.( I I I PRE-INCIDENT VALUE: Optional Other 002 1 0002 Property $1 000 000 ❑ Additional Action Taken (3) ❑ Check box if resource counts include aid received resources. Contents ,�'1 �', 000 000 ❑ Completed Modules Hl*Casual ties❑None H 3 Hazardous Materials Release I Mixed Use Property ❑Fire-2 Deaths Injuries N ❑None NN Not Mixed 10 Assembly,use ❑ Fire Structure-3 - I I � I 1 [:)Natural Gas: slow.leak, no e,.auati°n°=xe=Mat a°ai°na 20 Education use Service U LI Medical use ❑Civil Fire Cas.-4 2 ❑Propane gas: <u lb. tank (as is home aeQ g=Lil) 33 ❑Fire Serv. Cas.-5 3 Gasoline: vehicle fuel tank or portable container 40 Residential use Civilian�� 1 ❑ ❑EMS-6 4 ❑Kerosene: fuel burning equipment or portable storage 51 Row of stores Detector 53 Enclosed mall ❑ 'Required 5 [:]Diesel fuel/fuel oil:ve an or p 58 hicie fuel tank portable Required for Confined Fires. Bus. & Residential . Wildland Fire-8 6 Household solvents: home/office spill, cleanup only 59 Office use ❑ ❑ 1 Detector•alerted occupants QApparatus-9 ❑ 7 ❑Motor oil: from ea table container 60 Industrial use give or portable 63 Military use OPersonnel-10 2❑Detector did not alert them 8 ❑Paint• from paint cans totaling< 55 gallons 65 Farm use [3Arson-11 UE]Unknown 0 ❑Other: special aarMat actions required or spill >55ga1., 0O Other mixed use Please c lete the HaZt fors J Property Use* Structures 341❑Clinic,clinic type infirmary 539 ❑Household goods,sales,repairs 342❑Doctor/dentis toffice 579 ❑Motor vehicle/boat sales/repair 131 ❑Church, place of worship 361❑Prison or jail, not juvenile 571 ❑Gas or service station 161 ❑Restaurant or cafeteria 41999 1-or 2-family'dwelling 599 ❑ Business office 162 ❑Bar/Tavern or nightclub 42 9❑Multi-family dwelling 615 ❑Electric generating plant 213 ❑Elementary school or kindergarten 43 9❑Rooming/boarding house 629 ❑Laboratory/science lab 215 ❑High school or junior high 449❑Commercial hotel or motel 700 []Manufacturing plant 241 ❑College, adult education 459❑Residential, board and care 819 ❑Livestock/poultry storage(barn) 311 ❑Care facility for the aged 4 64❑Dormitory/barracks 882 ❑Non-residential parking garage 331 ❑Hospital 519❑Food and beverage sales 891 ❑Warehouse Outside. 936❑vacant lot 981 ❑Construction site 124 ❑Playground or park 938 ❑Graded/care for plot of land 984 ❑ Industrial plant yard 655 ❑Crops or orchard 946 ❑Lake, river, stream Lookup and enter a Property Use code only if 669 ❑Forest (timberland) 951 ❑Railroad right Of way you have-NOT checked a Property Use box: 807 ❑outdoor storage area 960 [-]Other street Property Use 1419 919 ❑Dump or sanitary landfill 961 ❑Highway/divided highway 931 ❑Open land'or field 962 [:]Residential street/driveway- I1 or 2 family dwelling, i NFIRS-1 Revision 03 11 99 COMM Fire District 01920 10/04/2008 08-0002981 K1 Person/Entity Involved Local Option Business name (if applicable) Area Code Phone Number OCheck This Box if Mr.,Ms., Mrs. First Name MI Last Name Suffix same address as I ' II II incident location. Then skip the three duplicate address Number Prefix Street or Highway Street Type Suffix lines. Post Office Box I I Apt./Suite/Room City' UICJ—ICJ State Zip Code More people involved? Check this box and attach Supplemental Forms (NFIRS-lS) as necessary K2 Owner Same as person involved? Then check this box and skip The rest of this section. Local Option Business name (if Applicable) Area Code Phone Number Check this box if Mr.,Ms., Mrs. First Name MI Last Name Suffix same address as incident location. I I U I I ICI I 1 Then skip the three duplicate address Number Prefix Street or Highway � - Street Type Suffix lines. I - I IJ Post Office Box Apt,./Suite/Room City State Zip Code L Remarks Local Option , Caller Name 328 Caller Phone 508-7902375 Caller Address : ON LOCATION OIC : INSPECTOR PULSIFER jgiff-ord ; 2008/10/04 08:44 :14 - 328 AT EVENT MANNING IS 1 jgifford ; 2008/10/04 09: 10:28 - 321 AT EVENT MANNING IS 1 jgifford 2008/10/04 08:45:35 328 OFF W/TOWN INSPECTORS FOR ZONING ENFORCEMENT INSPECTION jgifford ; 2008/10/04 09:02:54 328 REQUESTS 321 TO SCENE Responded with TOB BPD,� Zoning, Buildini and Health Departments for zoning enforcement. ` Arrived at 56 Elijah Childs Road, Centerville and.met with resident, Tadas Stukas DOB 02-19-77 lic #S95455861. Team identified and resident allowed entry. Structure is a single story wood frame residential structure with full basement. Investigated to find in plain sight in the basement two- 20 lb LPG cylinders, one LPG heater and one 20 gal. Rubbermaid Trash container with tubes and wires protruding from the top of the container. Questioned Mr. Stukas what the device is used for and he stated it is a hydrogen generator. There is no power to the unit and appears to be inert at this time. I asked Mr. Stukas what the hydrogen generator was used for and he ,stated for welding. . I advised him that I was a welder by trade prior to becoming a firefighter and have never seen a welding operation such as this before. I inquired what type of welding is being done to require hydrogen and he L Authorization 18300 I I GREENE, SEAN I ICAPT I I I 101 1 04 I 2008 Officer in charge ID Signature Position or rank Assignment Month` Day Year Boxcif 18381 - I I PULSIFER, FRANCIS I FIRE PRE—I I I J 1_2 J4 I 2008 same - Position or rank Assignment - Month Day Year as Officer Member making report ID Signature in charge. COMM Fire District 01920 10/04/2008 08-0002981 MM DD YYYY 1 01920 U 101 U 1 2008 1 1 J 08-0002981 000 Complete FDID State Incident Date Station Incident Number ve Exposure Narrati _] Narrative: Caller Name : 328 Caller Phone 508-7902375 Caller Address : ON LOCATION OIC : INSPECTOR PULSIFER jgifford ; 2008/10/04 08:44: 14_ - 328 AT EVENT MANNING IS 1 jgifford ; 2008/10/04 09:10:28 - 321 AT EVENT MANNING IS 1 jgifford 2008/10/04 08:45:35 328 OFF W/TOWN INSPECTORS FOR ZONING ENFORCEMENT INSPECTION jgifford ; 2008/10/04 09:02:54 328 REQUESTS 321 TO SCENE Responded with TOB BPD, Zoning, Building and Health Departments for zoning enforcement. Arrived at 56 Elijah Childs Road, Centerville and met with resident, Tadas Stukas DOB 02-19-77 lic #S95455861. Team identified and resident allowed entry. Structure is a single story wood frame residential structure with full basement. Investigated to find in plain sight in the basement two- 20 lb LPG cylinders, one LPG heater and one 20 gal. Rubbermaid Trash container with tubes and wires protruding from the top of the container. Questioned Mr. Stukas what the device is used for and he stated it is a hydrogen generator. There is no power to the unit and appears to be inert at this time. I asked Mr. Stukas what the hydrogen generator was used for and he stated for welding. I advised him that I. was. a welder by trade prior to becoming a firefighter and have never seen a welding operation such as this before. I inquired what type of welding is being done to require hydrogen and he stated ,torch style similar to oxygen/ acetylene welding. Mr. Stukas showed officials how the unit 'is designed: The 20 gallon Rubbermaid trash container is filled approximately 3/4 full of water and has a center dip tube made of 3 inch shedule 40 pvc pipe capped. Inside the PVC is a series of wires attached to carbon plates. On either side of the PVC is a lower grade plastic tube ' with a single wire protruding each which is given a charge by attaching a d/c converter. The process when operational, separates hydrogen from oxygen and the gasses off gas through a dip tube which contains the gas. I questioned Mr. Stukas where the welding equipment is located, none is in the immediate area. Mr. Stukas stated that the equipment is not-on site and indicated it may be at his storage site in Yarmouth. BPD questioned where the site in Yarmouth is located and Mr. Stukas provided a copy of his lease agreement. The, site is located at 37 Huntington Ave, Unit 41/ 42, South Yarmouth, MA 02664. It appears that the owner of ,the property is owned or managed by BEM .REalty Trust P.O. Box 386, South Yarmouth, MA 02664 and/or Sea Watch Realty Inc. 88 Falmouth Road, Hyannis, MA 02601 508-790-8000. Hand-written on the back of the lease is Bruce Murphy P.O. Box 386, South Yarmouth MA 02664 774-994-1261. I admitted to Mr. Stukas that the operation did not appear to be safe generating a volatile gas inside the basement of a residential structure in an unlisted manufactured piece of equipment outside a labratory setting. I did not notice any class 1 flammable liquids in the area and inspection of the LPG tanks and valve assemblies 'did not appear discolored. There was no laboratory equipment in the area, and when questioned, Mr. Stukas denied meth lab use with the equipment. I called for the duty officer to respond and confirm my findings and confirm no need for a hazmat team response to investigate. Capt. Greene arrived and was briefed of the situation, and investigated the same. Capt. Greene confirms no need for hazmat team response. COMM Fire District 01920 10/04/2008 08-0002981 MM DD YYYY 1 01920 U 101 U 1 2008 1 08-0002981 . 1 000 complete FDID * State* Incident Date * Station Incident Number * Exposure Narrative Narrative: Photographs taken by myself and BPD. Had Mr. Stukas remove the LPG tanks from the basement and dismantle the hydrogen generator. I advised him that he could not manufacture hydrogen in a non-listed piece of equipment, especially in a residential structure. Mr. Stukas acknowledged and understood and dismantled the equipment. Also advised Mr. 'Stukas to remove the plastic covering a smoke detector in the basement as well as several electrical issues. Main electric panel has cover removed and wires hap-hazardly attached. Multiple extention cord use in the basement as well. BPD requested access to lst floor and attic to verify no other activity associated with hydrogen making on those floors. Mr. Stukas allowed entry to the same, no evidence' was found on these levels associated with hydrogen making. Units cleared w/o further incident. Team members present were:. BPD Ofc. Danzinger BPD Ofc. Pass BPD Ofc. Sexton COMM Pulsifer COMM Greene Zoning- Anderson Building- Lauzon Health- Stanton 10/04/2008' 11:58:35 fpulsifer . COMM Fire District 01920 10/04/2008 08-0002981