HomeMy WebLinkAbout0064 GLENWOOD AVENUE k
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Post This:Card',So That.it is Visible,:From,tFie Street A sued PlansMust betetamed onJob and thlsCardMus"t be Kee,;t ,;9
M"R& Posted Until.F,inal Ins ection Has Been Made � � � ;,�u �" r� � � y=�
Permit
' �Wher:.e a Certificateof Occ-'u anc is Re aired,such�B.urldm sha_II NotbeOccup�ed urfil a Final Inspection;-.has b en imade�- ,, � ,
Permit NO. B-18-2847 Applicant Name: CEZAR A LANCA Approvals
Date Issued: 08/29/2018 Current Use: Structure
Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 02/28/2019 Foundation:
Residential Map/Lot: 190 120 Zoning District: RC Sheathing:
Location: 64 GLENWOOD AVENUE,CENTERVILLEIT
Contractor Name CEZAR A LANCA Framing: 1.
Owner on Record: CAMILO,TALITA ZEMA � ' Contractor License:GCS 102905 2
Address: 64 GLENWOOD AVENUE
Est Vrofect Cost: $ 12,500.00 Chimney:
CENTERVILLE, MA 02632 r r
Permit Flee: $ 113.75
Description: REMOVE AND ISNTALL NEW CABINETS REMOVE OLD CABINETS, Insulation:
a Fee Paid $ 113.75
REPLACE DAMAGED DRYWALL AND ADD A KITCHEN ISLAND
�' Date 8/29/2018 Final:
Project Review Req: KITCHEN REMODEL ONLY. �� y ;
� Al
c Plumbing/Gas
Rough Plumbing:
41
Building Official Final Plumbing:
Rough Gas:
4 " r a,
This permit shall be deemed abandoned and invalid unless the work autozetlby this permit is commenced within six months after issuance. Final Gas:
All work authorized by this permit shall conform to the approved application and the approved construction documents for U h"this permit has been granted.
All construction,alterations and changes of use of any building and structures shall be in compliance with the localfionng by laws and codes.
This permit shall be displayed in a location clearly visible from access streetIor road and shall be'maintamemed open,;for public inspect on for the entire duration of the Electrical
work until the completion of the same. VService:
c<
. i"W S "�
. .
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are:provided'on this permit. Rough.
Minimum of Five Call Inspections Required for All Construction Work:''"
1.Foundation or Footing Final:
2.Sheathing Inspection
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final:
6-Insulation
7.Final Inspection before Occupancy Health
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. Fire Department
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:
r
Application Number....................................................
Section 5—Detail
Cost of Proposed Construction /al, Square Footage of Project
Age of Structure Dig'Safe Number
t
# Of Bedrooms Existing Total#Of Bedrooms(proposed)
110 MPH Wmd Zone Compliance Method ❑ MA Checklist.❑ WFCM Checklist Design J
Section 6—Project Specifics
S
. . P
.s F
❑ Wning ❑ Oil Tank Storage Smoke Detectors
Plumbing ❑ Gas ❑ Fire SuppressionEl r
Heating System ❑ Masonry Chimney ❑Add/relocate.bedroom
s
Water Supply ❑ Public- ❑ Private
Sewage Disposal ❑ Municipal ❑ On Site
r
Historic District ❑ Hyannis Historic District ❑ Old Kings Fghway
Debris Disposal Facility: . I an using a crane ❑ Yes '60-No
Section 7—Flood Zone'
Flood Zone Designation
'11
Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑
Section 8-Zoning Information
Zoning District Proposed Use Lot Area Sq.Ft.
Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site)
Setbacks Front Yard _ Required Proposed
Rear Yard Required Proposed
Side Yard Required Proposed
Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No
Lasttmaated MMI8
' applicadonN=ber..... . .............:.........
4&g
�%,V
. 1 allOP Peffiit Fee.......................................Other Fee...................
I�A88.
�F Total Fee Paid.....................................................................
TOWN OF BARNSTABLE Permit Approval by................................oa........................
...
BUILDING PERMIT ... .................... arccL........1,2::®......................
APPLICATION
4 Section 1 — Owner's Information and Project Location
P:,roject Add. fG�l GL e Av woo AV village ��rai(t�Ll/g tte
0imers Name I i t tj CA-M t LO
y 64 Gl � Act
Owners Legal Address
City ���Ni yil�[.� State zip
Owners Cell# SOS I 01 E-mail "'J 14L!�a cAm Q CO.— �
Section 2—Use of Structure
Use Group ❑ Commercial Structure over 35,000 cubic feet
❑ Commercial Structure under 35,000 cubic feet
Single/Two Family Dwelling
I Section 3—Type of Permit
❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use
❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm
1
Rebuild ❑ Deck Apartment ❑ Sprinkler System
❑ Addition ❑ Retaining wall ❑ Solar
❑ Renovation ❑ Pool ❑ Insulation
Other—Spec (ALL ��v� C ►��t
Section 4-Work Description
-} K t i cuod t i�rN+1
l
T Act imdstrt:719201 8
ApplicationNumber............................................
Section 9— Construction Supervisor
Name (fd-21,n Z.lI-,AJCP Telephone Number �;0
Address I J� F�U 4LI)OC �i— City- >o State ,4 c-A— Tip Q1
P .
License Number 10o2-qV5- License Type Expiration Date
Contractors Email Cho,`"@ All C05�o-,,,QLAa2,V c&Cell
I understand my responsibilities under the rules and regulations for Licensed Constriction Supervisor in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and
documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. 9
Signature Date cJ_o� '' e�
Section.10—Home Improvement Contractor
Name C -2 Cam- " Telephone Number c���, 3&t` d_j 3-4-
Address IOC rho - City State ./14.,+ 'Zip
Registration Number Expiration Date to
I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and
documentaticq0q=d by 780 CMR and the Town of Barnstable.Attach a copy of your H.LC...
s--
Signature L Date (2
._.__ Section 11—Home Owners License Exemption
Home Owners Name:
Telephone Number Cell or Work Number
I understand my responsibilities under the rules and regulations for Licensed Constriction Supervisor in accordance with 780
CMR the Massachusetts State Building Code. I understand the constriction inspection procedures,specific inspections and
documentation required by 780 CMR and the Town of Barnstable.
Signature Date
APPLICANT SIGNATURE
t
Sipatur Date
Print Name C6 �- Telephone Number 509 ,_3600L/34—
E-mail permit to: C�OAII Q J'n C(, i oM U t9b - Cow
Section 12—Department Sign-Offs ,-:
Health Department ❑ Zoning Board(if required ❑
Historic District ❑ Site Plan Review Of required) ❑
Fire Department ,❑ a '�
Conservation - ❑ A
For commercial work;please take your plans directly to the fire deparbnent for approvab
Section 13—Owner's Ant "tion
L It j Pr C"��,,`L,� , as Owner of the subject property hereby
to act on m be m all
authorize C�Zvi ��� C� Y �
matters relative to work authorized by this building permit application for:
(Address of j ob)
O � /��`<�
Si of C er date
Print Name
Last wda#ed:2J9/2018
Office of Consumer/Hairs&8usiness Regulat or.HOME IMPROV'_MENT CONTRACTOR
�( TYPe: Ind,vidual
Re4istration
- -----_ oi
Ex__ ration
10/25/2018
Cezar Lanca
Cezar Lanca ', F i
13 Grandwood drive? �4 ,-
Forestdale MA b2�44 —
Undersecretary
public Safety
e a�ment of
D p
ulations and Standards
Massachusetts
Board of Building Reg
CS-j02905
' ,
®� License. Super
1 Construction Sup
a CEZAR A LANCA
OOD DRIVE 1�
13 GRANDW 4it
�Q FOREST DALE MA 0264A.a,
CIO
1 Expiration:
rr, Commissio ��---
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
ir .600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):�C�/1� iAuCR, `' L CU-5-1—o' L�G� VtAJV
Address: S5 UN 11
City/State/Zip: N�1S AAA Q�u1 Phone#:
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. 0 I am a general contractor and I
6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.J�J?am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g_ Demolition
workingfor me in an capacity. employees and have workers'
Y P tY• $ 9. ❑Building addition
[No workers'comp.insurance comp.insurance.
required.] 5. We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.&Other f Cures
comp,insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-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 thepolicy and job site
information. _
Insurance Company Name:
Policy#or Self-ins.Lie.#: Expiration Date:Job Site Address: q QrAj!�� AL City/State/Zip: (de4lI C1Lt d o
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under°Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby rtify under the p aloes of perjury that the information provided above is true and correct
aimafore Date:
Phone#: '5Q's3(00 lg4—,.
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#:
r -
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
i 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, §25CO states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents `
Office of Investigations
600 Washington,Street
Boston,MA 02111
Tel.#617-727-4900 ext 406 or 1-877-MASSAFE
Revised 4-24-07 Fax#617-727-7749
www.maw.gov/dia
Barnstable Assessing Search Results Page 1 of 2
;7
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00 WA � e
Home: Departments:Assessors Division: Property Assessment Search Results
New Search
New Interactive Maas >>
Owner: 2006 Assessed
Values:
SAD, LUIS L
64 GLENWOOD AVENUE Appraised Value Assessed Value
Map/Parcel/Parcel Extension Building Value: $ 145,000 $ 145,000
190 /120/ Extra Features: $2,500 $2,500
Outbuildings: $3,500 $3,500
(64
ailing Address Land Value: $ 169,400 $ 169,400
D, LUIS L
Totals $320,400 $320,400
GLENW 0DD AVENTERVILLE, MA. 02632
2006 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation)
Community Preservation Act Tax $41.70 fire District Rates Town
Barnstable-Residential $1.90 $6.31
Barnstable-Commercial $2.51 Commei
C.O.M.M. FD Tax(Residential) $339.62 C.O.M.M. -All Classes $1.06 $6.54
Cotuit FD-All Classes $1.33 Persona
Town Tax(Resid ial) $ 1.,390.09 Hyannis-Residential $1.61 $6.49
Hyannis-Commercial $2.50 Other R,
W � W Barnstable-Residential $1.60 Commur
_ W Barnstable-Commercial $2.46
Total: $ 1,771.41
Constrf ction�betails
Building Property Sketch Legend
Building vald`*e - $ 145,000 Interior Floors Hardwood
Style Ranch Interior Walls Drywall
Model Residential Heat Fuel Gas V Z_pA/
Grade Average Heat Type Hot Air
Stories 1 Story AC Type None
Exterior Walls Wood Shingle Bedrooms 3 Bedrooms
Roof Structure Gable/Hip Bathrooms 2 Full
http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO6map.asp?mapparbac 11/10/2007
i
Barnstable Assessing Search Results Page 2 of 2
Roof Cover Asph/F GIs/Cmp living area 1560
Replacement Cost $174717 Year Built 1964
Depreciation 17 _ Total Rooms 7 Rooms .
Land 3 `'
CODE 1010 J.
Lot Size(Acres) 0.34p<
3
Appraised Value $ 169,400
} 44a
Assessed Value $ 169,400
View Interactive._Maps_>
Sales History:
Owner: Sale Date Book/Page: Sale Price:
SAD, LUIS L Feb 14 2005 12:OOAM C175896 $360,000
LIMA, MAURICIO E Dec 20 2002 12:OOAM C167688 $232,109
DONOFRIO, STEPHEN J & DEBORAH F Feb 1 2002 12:OOAM C164205 $ 195,000
JACKSON, MARGARET L C61827 $0
Extra Building Features
Code Description Units/SQ ft Appraised Value Assessed Value
SHD2 Shed w/Elec 234 $2,000 $2,000
FPL1 Fireplace 1 $2,500 $2,500
SHED Shed 216 $ 1,500 $ 1,500
Property Sketch
Legend
BAS First Floor, Living Area FST "Utility Area (Finished Interior) UAT Attic Area (Unfinished)
BMT Basement Area (Unfinished) FTS Third Story Living Area (Finished) UHS Half Story(Unfinished)
0
CAN Canopy FUS Second Story Living Area UST Utility Area (Unfinished)
(Finished)
FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story
(Unfinished)
FCP Carport GRN Greenhouse UUA Unfinished Utility Attic
FEP Enclosed Porch PTO Patio Full Upper 2nd Story UUS (Unfinished)
FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck
FOP Open or Screened in Porch TQS Three Quarters Story(Finished)
http://www.town.barnstable.ma.us/assessing/assess06/displayparcelO6map.asp?mapparbac... 1/10/2007
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
lq6Map Parcel T1`01t,MCT PARNSTABLE Application
Health Division :f N a; + Date Issued �l ���
Conservation Division Application Fee
l
Planning Dept. 4 Permit Fe o
Date Definitive Plan Approved by Planning Board s>WT P1
Historic - OKH _ Preservation / Hyannis
Project Street Address
Village ccy4v,rV.j)
_ � r
Owner CJ1+1 1paroi 11 Address 5�Ac
Telephone SU- 6-Cc-'77��
Permit Request Iv,
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family 0' Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
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 Oarage: ❑ 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 INFORMATION - - -
(BUILDER OR HOMEOWNER)
Name Mike McCarthy Construction Telephone Number
PO Box 52
Address Wass Dennis, MA 02670 License #
Cell (508) 280-6964
C-2816 58633 HIC63 Home Improvement Contractor#
Email Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
Vr 01AM
SIGNATURE DATE
FOR OFFICIAL USE ONLY
• APPLICATION#
e
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
f'
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
Y
i '4
Town ofBarnstable
Regulatory Services -
x"R' ^ ltichard'V.Scali,Director
MASS
,,��► Buil lii�g Divisicin
Tom Perm,Building Commissioner
200 Main Sfit t,Hyumis;MA 02601
wsviv tojvn.barnstabie ma.us,
Of6ce: 508-862-4038 Far: 508 790-6230.
Prop, erty Owner Must '
Complete and $ign TWs Se-ctioii-x
if IJsAde1-
I� d I/a as(?c�mer.:of rocn the s>zbject y
herebyaudiorize C �� C �d to act;on mybaalf,
in all matters relative to %,Ork author" by this building permit appl.icarion for.
4(&Address'of�_,ab
"Pool fences. and aL= are the respansibil )r.of'che'applicant. P6615
are nov.to<be"filled-or'utihted-before'.fence is lmtated and all final'
uupectiom are.peifonned.and accepted.
Signature of Owner signat l:of:Applicant
/r4
Print Name Print Natxie
a6 .2311:� i
Date'
Q:Fa1tNISi0�V1�1'F�ETtT.tT55).ONYC�UL.ti ,- C�
s
G�
,.7
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor
License:CS-058633
MICHAEL J MCCkR - ';.
PO BOX 52 s
W DENNIS MA 8267
v'
Expiration
Commissioner 04/10/2016
Office of Consumer Affairs and BuS1neSS Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 169393
Type: Indivi
Expira n: 6/16 17 Tr# 264961
xi,MICHAEL MCCARTHY '~
MICHAEL MCCARTHY -{
P.O. BOX 52 �..
WEST DENNIS, MA 02670 — -
Update Ad ress and return card.Mark reason for change.
20M-05/11 . Address 0 Renewal Employment Lost Card.
` The Commonwealth ofMasraehusetts
Department oflnrlrtstrialAccidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/rlia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Pltinibers.
TO BE FILED WITH TILE Pi'RAflTT1NG AUTHORITY.
A licant information Please Print Le ibl
MikeMcCarthy ons rear ><
Name (Business/Organization/Individual): PO x 52
Address: West Dennis, MA 02670
Ce -
City/State/Zip: CSL HIC-169393
Are you an employer?Check the a propriate box: Type of project(required):
I.7m a employer with employees(full and/or part-time).* 7. El New construction
2.0 1 am a sole proprietor or partnership and have no employees working forme in $. Remodeling
any capacity.[No workers'comp.insurance required.]
3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t
9. ❑Demolition
]0 E building addition
4.❑1 am a homeowner and will be hiring contractors to conduct all work on my property. 1 will
ensure that all contractors either have workers'compensation insurance or are sole 11.E]Electrical repairs or additions
proprietors with no employees. "
12.(]Plumbing repairs or additions
5.O I am a general contractor and 1 have hired the sub-contractors listed on the attached sheet.
These sub-contractors have employees and have workers'comp.igsurance.l 13.[]Roof repairs
6.❑we are a corporation and its officers have exercised their right of exemption per M_bL c. 14.901her
152.§1(4),and we have no employees.[No workers'comp.,insurance required.]
'Any appiicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and Then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached An additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-conlractors.have employees,they must provide their workers'comp.policy number.
I am an eniployer ilint is providing)Porkers'compensation insurance for my employees. Below is the policy and job site
information. �^/k1 M
Insurance Company Name:
Policy#or Self--ins.Lic.#: VW(, -GCS( N Expiration Date:_
Job Site Address: ��tha c.� 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 MGL c. 152,§25A is a criminal violation punishable by a fine no 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.A copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify ury that tire-information provider!ob 7 veIs
' true and correctSi nature: Date [�
Phone#:
Official use only. Do not write in this area,to be compleled 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#:
t WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
INFORMAT=PAGE
A.I.M. Mutual Insurance Company
54 Third Avenue, Burlington, Massachusetts 01803-0970
800 876-2765
NCCI NO 26i58
POLICY NO. VWC-100-6017656-2014B
PRIOR NO. I VWC-100-6017656-2014A
ITEM
1. The Insured: Michael McCarthy Construction Inc
DBA:
Mailing address: P 0 Box 52 FEIN:**-***3862
West Dennis, MA 02670
Legal Entity Type: Corporation
Other workplaces not shown above: See Location.
2. The policy period is from 12/1.5/2014 to 12/15/2015 12:01 a.m.standard time at the insured's mailing address.
3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the
states listed here: MA`
B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A.
The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000,each accident
Bodily Injury by Disease $ 500,000 policy limit
Bodily Injury by Disease. $ 500,000 each employee
C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B
D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE
4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans.
All information.required below is subject to verification and change by audit.
Classifications Premium Basis Rates
Code Estimated Per$100 Estimated
No. Total Annual Of Annual
Remuneration Remuneration Premium
INTRA 0712979
INTER SEE CLASS CODE SCHEDU E
Minimum Premium $550 Total Estimated Annual Premium $29,332
GOV GOV Deposit Premium $7,748
STATE CLASS
MA 5479 State Assessments/Surcharges
$28,601.00 x 5.8000% $1,659
This policy, including all endorsements is hereby countersigned b P Y 9 � Y 9 Y 12/15/2014
Authorized Signature Date
Service Office: Bryden &Sullivan Ins Agcy of Dennis Inc
54 Third Avenue PO Box 1497
Burlington MA 01803 So Dennis, MA 02660
WC 00 00 01 A(7-11)
Includes copyrighted material of the National Council on Compensation Insurance,
used with Its oermission.
L
f .
it
Town of Barnstable .
of the
Regulatory Services
ram,
Thomas F. Geiler,Director
Building Division
BARNSTABLE, « - -
v MASS. Tom Perry,Building Commissioner
�ptE�MA�A` 200 Main Street, .Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790=6230
Approved:
Fee: A 96pp
Permit#:
HOME OCCUPATION REGISTRATION
Date: $ ZO
Phone ff: 524 t-5o ,
Address: 4 G�ev\wozzj Village: Co- ryi�e
Name of - ---_- -----------------
Type -
of Business: Mal)/U)t: �2Cf
r
INTENT: It 's the ii eut of thi section to alloW Cl. e residents of the I o�vu of Barnstable to operate a home occcipatiOn
Within single family dwellings,subject to the provisicins"of Section 4-1 A of the Zoning oi,dinance,provided that the activity
sti<tll not be clisceniible fronroutsicle the d«,elling: tliere_shall_be no increase iii noise or odor;'uo�isilat alterltion to the
premises Which 4voulcl suggest anything other than a residential use;no increase in traffic above n6rillat residential vohinies;-
and no increase in air or groundwater pollution.
After registration with,the 13,ullding Inspector,a customauy luinus occupation shall be liernlittec(,as.of right subject to the
following conditions: _
• l'lle activity is carved on by the pernianent resident of a single faintly residential cheeping unit;located Ivithiir
that chvelling unit.
• Such use occupies-no more than 400 square feet cif space.
There are no external alterations to the chyelling wlucll RtC not CUstolllaty llY1'esidentlal bulldillgs,and there is
no olitsicle elricleiice of sucll use.
• No traffic mill be generated in excess of Normal residential volumes.
The use'does not.involve the production of offensive noise,vibration,smoke, (lust or other particular matter,
odors,electrical disturbance,heat,glare,huniiclity or other objectionable effects.
There is no storage or use of toxic oi-harlydoUs materials,or flammable or explosive neaten lls, in excess of
,.
normal houseliold quaff tities.
• Any need foe parking generated by such tuse shall be ntet on the same lot containing the Custonlaly Honle
ncc•upation,and not«thin the required front yard.
• `(`here is no exterior storage or display of naatenals or equipment.
• hliere are no commercial vehicles related to the Custonlaly Hollle Occupation,other than one van or one.
Hick-uli truck not to exceed olie ton capacity,and one tInailer not to exceed 20 feet in length'and not to
exceed 4 tires,parked oil the salue lot containing the Customary Hoine Occupation.
No sign shall be displayed indicating the Custonlaly Hoiiie Occupation.
• If the.Customary Honle Occupation is listed or advertised as a business,the street address shall not be .
included..
• No person shall be employed ili the Custonlary Hinne{)ccupat 6 i a 110 is'[tot a ptrn)almitresident cif(lie
dwelling unit:
I, the undersigned, ha e read,and agree,'reltli the abov6 Ie l (tioiis for Illy hotlie occ•upatlon I.,alll 1'eglstenili,.
Applicant Date: 2�loo-LI
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business Certificates COST
(WHICH YOU MUST DO BY30.00 for 4
at 200 Main St, M.G.L.MGL - it does not give you Years. A Business Certificate ONLY
the Business Certificatelthatiss. keeq e completed form to the Toperm fission to operate). STERS
You must first obtaint el neces YOUR
n Clerks Office, 1'' FI., 367 M NAME
Y la
w. Main St. H sarY signatures on his form
Yannis, MA 0260
(Town Hall) and get
7
sty". Fill in
pie
ase:
a M n{ l APPLICANT'S
YOUR NAME:
Q DATE: g O.
BUSINESS . :
�-----=—
YOUR HOME ADDRESS:
TELEP p E ZLE..
NAME OF NEW BUSINESS�} ' i rz M�
Home Telephone Number: 2�e 2
IS THIS A HOME OCCUPATION? _
Have you been given,a —YES NO n'PE OF BUSINESS Cans PP!�ov 1 from the building division? YES
ADDRESS OF BUSINESSY-V Coe
Qv �N O
When starting 02
b a new business there..are several -MAP/PARCEL NUMBER -
Barnstable.
This form is intended`-to assist.you in obtainin
'thingsyou must do in order to be in compliance with the
Yarmouth Rd. & Main Street) to make sure g the-information
town: you may rules and. regulations of the Town.of
. you have the appropriate Y need-. You MUST GO TO 200 `
permits and licenses, required to legally Main St. — (c
It 'BUILDING CO (corner of ,
ISSIO lly.operate your business in this
This indivi ual ha ER'S OFFICE
en inform d of an
�J Y er it req iremen
A ts that
pertain to is type of business.
COMMENTS: ori ign ure** MUST COMPLY WITH HOME
RULES AN OCCUPATION
D REGULATIONS
2. BOARD OF HEALTH FAILURE Tp
This individual h
e inform d e per -
equirem is that pertain to this type of business..
COMMENTS: Authorized Si ture**
MUST COMpLY rrH ALL
3. CONSUMER AFFAIRS SREG
This individual hasLbeen�nlfo med NG 7oHOR1TYj ELATION
e licensing requirements that '
pertain to this type of business.
COMMENTS: Authors ed Si nature**
�. i
�F1NE loy, Town of Barnstable
Regulatory Services
BAMWABM
MA & Thomas F. Geiler,Director
039. 10 Building Division
Thomas Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
January 13, 2004
Mr. Mauricio Lima
64 Glenwood Ave
Centerville,MA 02632
Map 190 Parcel 120
Dear Mr. Lima:
This letter is a follow up of our conversation on 01/08/04. At that time I informed
you that the property at 64 Glenwood Ave. is a single family residence and cannot be
reconfigured to apartments without the approval of the Zoning Board of Appeals.
Also you might try the Town of Barnstable Amnesty Program see enclosed brochure.
If you are successful with either of the above,the apartment would have to comply with the
latest Mass Bldg Codes.
n rely,
ck Fitzgerald
Local Inspector
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3D View
Room 1
Doors: 3/4"Solid MDF Shaker
Style �
ct3
Back Island Doors: 3/4" Solid C
Red Oak Shaker Style O
J E m
111 �
Finishing: Satin Painted Grade (6 Q
and Jacobean Red Oak U
W Color: Simply White 2143-70 0
Ln
_..----._. .. _,_.... -- -— --- ------- -------- 2 w_
Jacobean Red Oak: Back
xr
i Island, Floating Shelves and
Wine Rack �
CO
#24 #23 #22 #21 o
Crown Molding: Flat 1 1/2"
N Height co#29 7
w
N#3 Lite Rail: Square QO
CU
# 5 #26
I j Acessories:
N �
Cabinets#10: Corner Solution = E
co Le Mans II Swing Right o
#5 w O° c?
LL
#8 00 Cabinet#5 and#11:#2 Pull Out o
Drawer C N CO a) E
D CO — N p
} � NCO +�
Cabinet#15: Cutlery Divider U M 6 00 L
D (Top Drawer) O � --— 1=
-- - -_ ._.._. _ N � co000 ..
l� - LO
Cabinet#13: Tray Divider Pull u_ o c"o
Out 0LO Qr � � o
#14 #13 #12 #11 #10 TN n- 0- EL u
4�6 N Cabinet#14: Spice Rack Pull z
- --- w Out OD
#19 #17 `i 3 E
Cabinet#10: Double Tie Drawer V
#2 Below Drawers) .�
._.___ ____ ._._ _. _. I Cabinet#26: Trash Bin Pull Out, Page ,
70 1/4 14 30 14 18 3/4 18 3/4 44 1/4 Double
5 5/8 1 15/16 3/4 1 11 16 1
�-13 1/4-- 33 13 1/4 19 9/16— �— 33 1/4 -- 26 Escale
3 1/8 3/4 5/8" = 1'
- - 220 Revision Date
8/17/2018
142 13/16 Page Name
1
Floor Plan