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HomeMy WebLinkAbout0015 GREAT MARSH ROAD �� GHAT M�s�' za a�u i�3 PERMIT Page 4 of uildings 43 i MA A .....................:_..__..........._.....__._._—_____.........._.__..._.__.__.....__..__....._�............._._._. building.. ... . , ................6 permit...'....r`. 4: L of any new building,and ae, permits......................... . z r other...Treasurer until an upancy permits.No building. . ............ ...........z permit...................._. ,......3 h the...Failure to obtain a Imis5ioner.Failure to... _..........__..._...................... ._...._......_._..........__...:._........................_......._.__......_.............._._.._...__..._:._.._...._._........_.._...................._......_.. �6 � 77 �`fave 4v p> ✓Co G;4T7B-4� BUILDING PT JUL 2010 16 TOWN Off=BAf�NQTAS,- . 0. Town of Barnstable Building Department ComplainVInquiry Report .A E Date:_ Rec'd by: Assessor's No.: Complaint Name: Location Address: R e/L m l C/? f,tj )4 `s �°�-c�� C&,,?P1ev17/e M/P MMW7Name• C � l e?4" D Z U V,llage. `./c?2✓/lG _ F State: Telephone:D/C 7 -2/ Complaint ca- Desmpuon: �� 2 Gtat� �� j�•CG*v��eR a6 �Q2 T d�� Inquiry Description / loM/iI e�J�!Z/ r7 &Page,me a ka 2e ox �eojle `ivi 1 :k ev're-r o cep K cr 1�o r& ,tp 6 cadre of Me ' Fpr Office Use Only c-o� 4 e/�Aai :�U p 2 �.0 0 Al 41 . Z tfCi' Inspector's Welt e odr �vo%Ge- a.,e yKvs�'c � e Sze Action/COIae/.1 f . 17ate�� f l f Ps` i ka t i pectort: • r Follow-up Action Additional Info. Attached Copy Distribudon. White-Deparunent File Yellow-Inspector Pink-Inspector(Return to Office alanager) 77, ., Complaint Number: 1713 ;Taken bv: .J_LQING S_ERVLCES Date: 4400 Man/parcel: y Referred,tor 01 mSUBJI1JCTOF COMPLAINT . 4 , Business/,Occupant Name: �w • a,T =mA, Number #, 0 Street:, COR. OF GREAT MARSH RD./PHINNEYS I Villave:; CIJN EIZVJLLE _ COMPLAINT-INFORMATION - Complainant'sName: E. DIAZ - Address: 15 GREAT MARSH RD. CTVL: woo ­Z Telephone Number 771/2084 F - m -Complaint Description ° LGE NO. OF CARS----LOUD MUSIC-- LTC ALSO UN-REG CARS. vs n m' .iw „� g ,..., -ems =-_-gs • -0,-t`- .- ...vx —.- .,.. ,. s 2,,,,.,•� : �. s -Actions Taken/Results:, REFER TO R J. BLDG. DEPT. AND B.P.D. Ak a �w x ' Date Closed: w F THE Tp� ' . � The Town of Barnstable 9�AMAE& Department of Health Safety and Environmental Services rECN,►�a Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner PLEASE FORWARD THE FOLLOWING TO: TO: ATTN: Ina (71"f- 0;�a-Z-7�- FAX 7 �6 - 6J / 7 FROM: ��ev DATE: Pages (excluding cover) Message: q:formsAcsimile J Py�fTMEto�♦ TOWN OF 'BAR NST ABLE i BAUSTME, i "6 9 �e� DILDING INSPECTOR 0 MF a • s . APPLICATION FOR PERMIT TO ......... z........Z�"K&....�.......................... TYPE OF CONSTRUCTION ...........`'..C%a.0....... 1...1.2�//l� ...............::....................:.:.......'......:..:.................... ...... ..`/ .-..................19Z TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....4.7.....3.........4%1/2,t, �� ......Jig�2SFf ........................ ..... ......... ........................ .................... ProposedUse ...... ....................................................................... ...................................... Zoning District ......... 6................h../. ............................'..Fire District ..... ��!��!` dT.................................. 57'L�� .c �• / 7�/2a572oy _ l� Name of Owner ... ..... `..............................................2r2 Address ....... .......` /?z/..7rz S. ✓! T ....... .lir/� Name of Builder .................�'.........................T!:.!.Y.. . ..zl�Address ...........1.�/�C..��:5..:.../9-Th`........../..�`y`.1��............. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....................7............................................Foundation Exterior ... /l! .. ..e`..... ��/3d 2�.5.........Roofing / %7t�4.C�. ....................................... Floorse /z �G(i......................................Interior ........... /'� ................... ............................................ Heating � `�..�� .....Plumbing �C Fireplace / n Approximate Cost .,Q..Q,® �` p ............... ......... ......... ......... ..... . ...... Definitive Plan Approved by Planning Board ________________________________19________: 17 17 Diagram of Lot and Building with Dimensions ® � �G — �, SUBJECT TO APPROVAL OF BOARD OF HEALTH SE1 l uC e"'1S1 F r=,A6' BE �- •. ffl 0II 1-7 19 J �a dA ,Z-7 t h 7,4' 60 /Dd � I hereby agree to conform to al the Rules and Regulations of the Tow of Barnstable regarding the above construction. �--- Name ........... ................................... Nordstrom. Stephen L. & James F. Horrice No .... -Permit.-forR.....one st2........... .. .7.......... gqjr�a,� . ............. �4ng..... ................... Location k�.Areat.,.Marsh...Road................. .. ........ ........... ......... Centerville I e ............................................................................... OwnerSt Nordstrom & JamesF. Horrice ... ............................................ Type of Construction ...............frame...._._.......... .. ................................................................................. Plot ............................ Lot ........ #3............... Permit Granted d Februax7 15 97.3 .. ........... Date of Inspectit/ ................................19 71 Date Completed ...... ......... ...10......19 7,5 PERMIT REFUSED � ....................................... ....................... 19 5 S 7o 6 7 oo, ............................................................................... ................................................................................ ............................................................................... .................................................................... Approved ................................................ 19 ............................................................................... ....................................................... .......... i c� Town'of Barnstable *Permit# of I Regulatory Services wee 6 date = BAMSPABLE,.+ MIAS A,� _, 2 6 2417 chard V.Scali,Director �� [p Building Division n 11�S' ®® Paul Roma,Building Commissioner ADLE200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Inprint Map/parcel Number d b LProperty7A ess �Q�T S f'/ I�CJ�9 t� �'e&_ llI L I- -e In ❑Residential Value of:Work$ / ,ClC9® Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address— L /f}4,d 0/ k -z Contractor'is�Name__ S'tiD�v CO2 T TelephonetNumber 57—b l� 7 7/ 17Xa' Home Improvement ContractonLicense#(if applicable) lJag-/ Email: Construction Supervisor's Lict„nse_#(if-applicable) C, S_ 00 `ZS�S S' ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum 32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: jeop erty Owner must sign Property Owner Letter of Permission. py of the Home Improvement Contractors License&Construction Supervisors License is ired. SIGNATURE: QAWPFILESTORMSUIlding permit forms\EXPRESS.doc 01/25/17 - r `T � .�1�e0II1T13'olrfiUP.Qt�f�fLSSlft�t �S DppaStweirt elf ludusl7Zal Accide?nt . ' 600 Washington S iwt A -- Bowtfin,AL4 02111 t nneinam%govliiia Workers' Campensa£imtInsum-ance r'id�-Bm1de7dCtrntractars ect ic«„r1Rhiinbers Infaa Please Pit Iv Add��s: � ��o,,g•-e �0/dT ��_�:��•2i S rl'I,�• e�a�e�� . �i V. Phvna-&"_­ 771 Are you an employer?C eelctheappropriatebam ' T of reject r L❑ I am a 1 u�li 4 ❑I am a general ccmfractor and I � e ] ( ��d}: ,FMPIoyees(full aedfof part-time).** 1mvehiredthe sub-corm 6_ ❑Item deHngr�i� 2 a sale proprietor orpartnw- listed onthe'af#achad sheet` �- ❑RPmode drip and have no employees These sub-cadfractors ha7e 8_ ❑Demolifioa worldne forme is airy capacity. employees sad har,e wo&ers' 9- ❑Huifdin�ad3ifi� LNO vupdomw pomp,innuance comp.imrMMI rexlaired f I ❑ We are a corporatim and its la ElEle#ca repairs or additions officers have�esercised flsei ❑Phr 1L mrbia r ditinns I❑ I am a horneo�er doing ai>;Mork � ePairs ar ad myself o workers' tight of exemgfion per MGL v � �F c.152, 1 andweha�reno 1.._❑Roafrepairs • irncreianr•.e required-][ ( employees-[To wozkh=' ❑other. comp.msnrarme required.) •Any appffczntdmt cbedsbas#1 mnst also Mcutths sw ioabeIW sh ndag 6e's•wodcere campenMffnupeHcyinformsorm. &ameawaers who sabniit risis afiida[di i catmg tbey are daing 0 vrc&attd oboe hie autade cant +m=maA.submit a newafd2rdt iadiesbno s=b_ ICa osiii�checYihisbox mastxnadsedasaddifi-21sheetsbovdngthensmecfthesub-cau=ctos sad styewhhegmtarnot$mse lirm enrpkgees.'If thesnir-c�haveempIcyEe%they mnstPM-ZeOwk wodkea'tomp.parryaumbet lain art sarploysr flout;fsprai idbz,-.warkers"compewdian grsararrca far rrr}* Topes $eNv is thapaficp and jah site ce Gompany-tEame: T tPaficy�tar�eFfri�_I.ic_� FrSpiratiaaDate:- Tab Lddress City15 ta# ,Sg Attach 2.copy cdthe workers'rs'compensationpolicydeclaration page(showing the policy nutaber and expiration date). Failure to secure coverage as requiredunder Se-ctiaa 25A of MGL c�152 can lead to the imposition of crimbW penailaes of a 3me up to$1,50D.OU an&or aae-yearimprisoumeut,as ate31 as dvil penalties,in the farm of a STOP WORK ORDERand s fime of up to$250_M a day against fhe violator. Be ad;rised fat a cagy of this statemennt.maybe f wwnded to thB Office of Invedtafiarrs of the DIA for insuranee-coverage veri$ tiaa. Ido heir lbv car* rer tltet pairzs d per1aItc>'s 4fpedW7 flr&&s irrfarwa6wtprovi&d aboto!s tt m and carrect '— P-- Q&kd use wily. Do not svrike in tIds area,to be nnzT&eeJ by city art2n.11 nJy"re&L City or Town: PermitTAce:nse# LIMIling Antltar4(drcle one): L Board of Health I RniIffing Department I C<ty-1Town Clerk d.Electrical Inspector 5.Phutbing hupector 6.Other Contact P'e:rsom phone 9: --- --- 6 laformation and lastruefions .. I fassach,=,t Geteaal Laws chapter I52 rsq==aH culpIoyCIS to provide VDT'caml'ensEflm for t ea employees- p to this ,an n7q LV=is defined as.`°.CmY person,in.11ie service of anoalm under any contract oflihe, express or iinpHe4 oml or wrJffruf An defined as-an in�idual,paiineMEP,association,c:orporafion or other legal mffiy,or any two or more . of the fnregoiiig - J � of a deceased emPIoyer,or the ma Dint andmc1n13mg$zelegal �� receiver or tust,=of an kavidiral,p ,assocfifion or other Iegal entity,employing employW- However the owner of a dwellinghorsehavingnotmore thaathreeapartmerds andwho resides therein,ofthe occad ofthe- &mMag house of another who employs peisans to do maini �.rrn,cf•raC [Zn or repar wort.on such dwelling house or an the grounds or bm7.dmg app,�,,taz¢thereto sh.Unotbecanm of salt emplaymentbe.deemedtO be an employ." MGL Chapter 152,§25g6)also sues that¢evaT sb Ete nr local Iice d g agency shall WrthhoId$e issaance ar mae�al of a license or permit to operate a bmskess or to conctrUr-t bmldings in the commanWealth for nay applicant•wgho has notprodtaced acceptable evidenm of c6m-Prance with f$e iBs¢rance coverage raquired- Ad.diionally,M Er,cbaplPa 152,§25C(7)s(aits-NDitb=f7ie c=m=- Wealth nor any of its poutical snbaTisions 4211 mfYz- into any coatrad inr the perfotmm=ofpublio work aatl arz-eptable evidence of oamplianc Whh the insm7ee:.- r ems of t3ais rhapt�r have been pierM±Dd to the can,, .zg aufh of Vf Applicants Please fill Dirt the wod''compeusafion a$davif comple#ely,by rig the boxes apply to your situation and,if necessarp,supply sob cons)ne(s), gy m) Phone nnmber(s)along Wi h_ffiMr=tfi a±e(s)of ; zozance. Lid Li bil�y Companies CUC)or Lmnted.iabEityPa�ships(LI P)'v�hno e�Ioyee s other ih e membCU or pa¢bners,are not rtgpd to cagy wolf-ere compensafion in=mc, If an LLC or LLP does have employees,apolicy 19 regaked. Be adyisedf3iatthis affidayitmaybe sobmitted to the Department of industrial Accidecjs fbr confumaf on of msm-m=r°vera96 Also ho sin a to sign and date the of davit: Tho affidavit should beretnmedto ,$ecityyortownfhattheapplicationforthepenDitorlicenseisbergrequested,nottheDeparizne of Tnrh,car;aI�gsoid,�,�s ghMIdyoa have any gnesdoas regm-dIng fhc I&w or ifyou are regaited to obtain aworkers' compensation policy,Please caa the:Department at the number Eyted below Sf-jf-rosined couPanies should enter.$heir self-i �ce license=Mbea on the line. City ar Town Off ri2k - t Please be sore brat the affidavit is complete andpt�ed IegIIy. The Dep2ementhas provided a space at the botb= oft affida�for you to fM out in the event the Ofice ofluvcshga has to c 16a,- you rc g tb_e licant_ Pleas e be sure tD fIl in fb.e p .itlli reuse nvmbex which wiIl be used as a ree ffice=mben In.addition,an applicant that must=bmit MuI#Ple perm�fficeiose applit�S n in any em ycer.need only solunit one affidavit md� cat policy inforraatiom gne�y)and under-Tob�e A -d&-c "fie applicant should wr6e-au locai>s:na fit (may or town)^A copy of the affidavit that has beea officially stamped cr marked by flee ar town maybe provided to flee applic=t as proofthat a valid affidavit is on file for fl:dm 'pcu its or lIMMM A new affidavitmust be:filled ort eia.ch. year.-Where,a home owner or citizen is obbaming a license or permit'not related iD any business or commercial Y� a dog license orp,=ak to bum leave s e#---)sauipm-son is NOT ruFd rc d to complete this affidavit Tho p�o f In��gs ter. wouldl m tD thank you in advance for your coopeaatiaa and shouldyoa have any gnesiZons, please do nothesifate to give as a caM -Me,l}epartmenfs ad&=.,telephone and fax rammber- - �c��Accid�nts • . a l&oil II • Fax#617-727-7M 1Zevisexl424-07 9PvIca r f Snow Const cation,, TrimrCoverage Specialists • Vinyl Siding Combination Windows•&Doors•Replacement Windows•Seamless Gutter Systems Licensed Massachusetts Contractor 8 Homeport Drive Lic.#007855 Hyannis,MA 02601 Member of fthe Better Business Bureau H I C#112818 Telephone(508)771-9366 Date: 5/1/2017 ..................................................................................... Purchasers Name: Emiliano Diaz Telephone: 508-771-2084 Address: 15 Great Marsh Road-Centerville,MA I Purchase Agreement •••• , Contract Agreement I/We,the owner(s)of the premises mentioned below,hereby contract with and authorize Snow Construction as a contractor to furnish all necessary materials,labor,and workmanship,to,nstall, construct,and place the improvements according to the following specifications,terms,and conditions 1 on the premises below described: .Owners Name: Emiliano Diaz Telephone: 508-771-2084 Job Address: 15 Great Marsh Road-Centerville,MA REPAIR WORK:No repair work shall be done,except as herein specified and,expressly agreed to in writing by the Snow Construction. Specifications Supply onsite dumpster.Remove alll cedar shingles on main house and(3)sides of shed and put into dumpster. (Apply typar house wrap on same exterior walls. Remove clapboard from farmers porch and dispose in dumpster.Put typar housewrap on same wall. Supply and Install Mastic double 4 inch colonial yellow.solid vinyl siding on all exterior walls of home and(3)sides of shed. Supply all necessary light blocks faucet blocks and electrical outlet boxes.All blocks to match vinyl siding. Supply and Install(2)pair of white Girardin vinyl closed louver shutters. i NOTE:Any additional suffers cost to be added to contract price. < Job to be started June 1 st or possibly earlier with owners permission.,yj-,i! .,T,cam.;30 Materials and labor cost: $12,000.00 ` Down Payment 4,000.00/Midway through job 4,000.00/Upon completion 4,060.00 Contractor will do all of said work in a workman like manner: Owner agrees that in the event of cancellation of this contract before work is started,owner shall pay to Snow Construction on demand twenty=five percent of the contract price as liquidated damages`for the breach.No work to be done on this property other than specified on this contract without additional charges.All verbal or written agreements not mentioned on the face of this contract are void,and no salesman has any authority to change,alter,or add to this contract in any particular.This contract contains the entire contract between the parties.A copy of this contract is hereby acknowledged and received.This contract is subject to strikes,accidents,or other delays beyond our control. 'y/ In Witness Whereof the parties have hereunto signed their names this day of --�` a017 Sno Construction R presentative: Property Owners: Print: Print: Sign: Sign: Vol.w "&k 0/1b' � Office of7Consumer Affairs&Business Regulatton' r OME IMPROVEMENT CONTRACTOR; 0. egistration818~ Type: Expiration p 4/2Z/2017 DBA SNOW CONSTRUCTION ,�f JOHN LOPEZ 8 HOMEPORT DR A HYANN'IS,MA 02601 Undersecretary �. Massachusetts Department of Public Safety Board of Building Regulations and Standardslug ` License: CS-007855 Construction Supervisor s + JOHN R LOPEZ 8 HOMEPORT DRIVE �;f . HYANNIS MA 02601 'J I ff (�,�n lJ�- Expiration: . Commissioner 04/28/2018 t ., License or registration valid for individul use only before the expiration date. If found return to: office of Consumer Affairs and Business Regulation x. 10 Park Plaza-Suite 5170 Boston,MA 02116 t i I natu Not valid without ig i $Construction Supervisor ' Restricted to: OHrestricted'-Buildings of any use group which,contain less than 35,000 cubic feet(991 cubic meters)of enclosed'space. Failure to 4ossess a current edition of the Massachusetts State Building Code is cause for revocation tof this iicerise. , DPS Licensing information visit: WWWRASS.GOV/DPS - e COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation Home Improvement Contractor Registration Program 10 Park Plaza,Suite 5170 Boston,MA 02116 APPLICATION FOR RENEWAL OF REGISTRATION. HOME IMPROVEMENT CONTRACTOR OR SUBCONTRACTOR MGL Chapter 142A,201 CMR 18.00 WAL FEE: ONLY CERTIFIED CHECKS YMEI II�TMONEY LtORDERS CUrN BE NOT LDMTED TO REQUIRED RENE ANy OTHER FORM OF PA $100 PERSONAL OR BUSINESS CI�CKS, WILL BE RETURNED AS INELIGIBLE. PLEASE OCABR will not process any renewal application if it is postmarked more than 60 days beyond the expiration of the HIC Registration. See 201 CMR 18.02(6)(b). Failure to submit a timely renewal application will NOTE: require a contractor(1)to obtain a new HIC Registration card wit ne�v HIC Registration number,(2) h.a to a associated fees,and(3)to u date all advertising with the new HIC Re istration number. 1. Name of Applicant as listed on Current Registration: John R Lo ez 2. Registration Number: 112818' 3. DIBIA used by Applicant(if different from current registration): (If filing as a new DB/A, you must provide a copy of the Business Certificate filed with the City or.Town Clerk.) 4. Address/Telephone Number of Applicant(if different from current registration): Telephone#: 5. No.of Employees(if different from current registration): 1 6. If Applicant is a Partnership,Corporation,or Trust, indicate if d t event from current registration)he name,Soal Security No., d contact number of the individual responsible for Applicant's work : First Middle Last Telephone#: CHANGE IN LAW ABOLISHES CSLs HIC RENEWAL FEE EXEMPTION.Supervisor ssLice Lic a result enses no longer exempt from HlCf a recent change in the law ection 80 of Chapter 27 of the Acts of 2009), the holders of Construction Registration fees. CONSEQUENTLYEWALOFEE OF 100 00 INCLUDING CSLs WHO ARE RENEWING THEIR HIC REGISTRATIONS MUST PAY A RE 7. Registration Renewal Fee enclosed:$ l00 sett ONLY CERTI IED CHEC Make all fKS OR MONEY ORDERS CAN payable to ,Commonwealth of Massacied checks or money orders husetts. BE ACCEPTED. Pursu nt to Massachusetts General Laws Chapter 62C§49A,I certify all state taxes required under lawat'to the best of m n wledge a belief, I have filed all state tax returns and p Owner Date Signature of A icant Title held, if applicable A FALSE ANSWER TO ANY QUESTION IN THIS APPLICATION CONSTITUTES GROUNDS FOR SUSPENSION OR REVOCATION OF THE APPLICANT'S REGISTRATION. Town of Barnstable *Permit# . ties 6 months from issue date Regulatory Services �ee I EAMMM MAS&s. Richard V.Scali,Director EON1�`� Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barmtable-ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number iPfop&ty`Address ❑Residential V.?,ofva k$ '4 ,ew O Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address /�► L /.f} �/ r} Z �� zx . q .. ,k,�.y#kff,±SQ'�„`d Contractor'sNie �"" s S2DGv CO2ST Telephoiie�Numberd� 77/—�3CC Home Improvement Contractorl License#(Lf apphcable) �°f��/ _ri 4a l Construction Supervisor's License#cif a li ble ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: operty Owner must sign Property Owner Letter of Permission. copy of the Home Improvement Contractors License&Construction Supervisors License is equired. -SIG ATURE.� , QAWPF7I. TORMS\building permit forms\EXPRESS.doc 01/25/17 I Ile Cammornrea1dt gfMassa&uYdts epr� eut cr rtdi trio!Ac d Ogre-o, bwelagatirrns . . 600'Washingtou,street Gastrin,CIA 02111 ' kurv�asrx�crssg�v�iiirt Wm-kers' Crmzpens2EmTnmu-mcoATni -Bmlder-dCantractursMecbi LmLJP ambers ApplkzntInfarm.a6m Please Print Le. Phan - 7 C Are you an employer?Checkthe appropriate bay ' T of project r ,. L❑ I am a em I w�. 4 ❑I am a general conkactor.and I Yi}e e J frc� P� * liare]sired.�e su�r��..F,,,.s 6. ❑l�e�consfraction loyees(fell a�for pa�fime}. am a sole proprietor orpmtxr- d oailiE aftacfied sheei~. 7 ❑Remodeling Theme sub-condrac-tom have scup and have no employees $.,❑Demalitioa g fauna is employees andhace wodoere o „ �Y��`- 9. ❑Suite ad3ifioa. 190 wpdom ' comp,fusuncocei Comp_i Lw13 ttr$ reciaked-] . 3. El We are a cmPmmfiouand ifs 10❑MeFffk2l mpaus or additions 3.❑ 1 ama homeorumer doing all work officers have exercised their 1L❑Plumbiagrepi-=or additions. a:e tight of em=pfion per MCL �sel€ o woi� i - .1.5Z§1rr` azld b no we L..❑Roofrepairs irnsnsance d-i 1 c � • employees_Wowozke& 13-❑Other cofl>zp-]IImmm required_] '$ayappFi�t�s[cbectsboxiRtaa alsafiIlo tit�se[tioabr7mat gaiea�ua$cexs'ca®pe�salinapnTicgi msFse� #ffo-meaara�svdwsutmgtdzisd5dwifinffic tm 9abmitaaewxMd2vstiadicstinosacFi fCammctbgi3�2d�ecYiltEsbmcmasta3larhe�ffiaddiS®slsixeeSs'�oa�agtlscn�.Hof►hesnb-ca�cfas�Ilst�etebethesarnnt�nseehsti� mpbyees.Iftbam cameo eskm mplayee%dfiermsrprc &&eir warkmec=p.paaynumbm I am ars ersp1qj-w Mat isprm-2hrg irariiers compensation in=rmicefor my emIA4,zes: $ei'nry is fhspo cg and jab site Frr�Orril[r�OrL . , &,gonxpariy name: R Job rdressMEp . Attach a copy of the wart ers'compensxtionpolicy-declarafim page(showing the poficy number and expiration 32fe).' Fad to sew coverage as requirednuder Section:25A of MGL a 157 can lead to the imposition of criminal penalges of a 3me up to$1,540:OU aadl'or one-yearimprisonraeA as Drell as ciO penslfies in the form of a STOP WDRF ORDMand a:Eke of up to$250_00 a day ag-ainst the violator. Be adcdsed fliat a copy of this sfiatement nay.be Ek arded to the Office of Imtes igadpw offm DIA for iasv ce coverage wriflCatica- I rfa hereby. can rder d1SPM-M%ndpv=1ftrjaf Faxyatff[e bt,farmamt prmrd abw�s is bps and correct Piiane knv - af�i�eaL��!F}: Da itat Narita�t tF��xea,�r be rrrrlspletcsd�p cifp Qrtan�u n;�cu2t . CRY or'Fawu• Perffifff ease Ezzi g Anihoir€tp(cucleone): L.Berard of Health'r.Sum Department 3.CftyIrosm Qerk 4.Electrical Iuspeetor S.Phombing Eupector 6.Other Contact Person: Phone#: — — -- 6 tom, Town of Barnstable *PermitJ,6130?_" � Expires 6 n o► hs,&gmVt Regulatory Services Fee f * BARNSTABM 039. $ Richard V. Scali,Interim Director QED MA'I a Building Division Tom Perry,CBO,Building Commissioner 200.Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number�� �,o j 6 3 L o6r•:2 ��- L Property Address Ro 0 ❑ Residential Value of Work$��/D,o©o Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address a Contractor's Name AA7 Telephone Number_!t a-p p o 7�✓r Home Improvement Contractor License#(if applicable) 1 O a 3 d, Email: Construction Supervisor's License#(if applicable) U D ❑Workman's Compensation Insurance XPR ESS Check '� ❑ I am a sole proprietor ❑ I am the Homeowner NO V j 5 2013 Q I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# W C 1/0-0 -74 d 113 a UA TABLE- Copy of Insurance Compliance Certificate must accompany each permit. 3, Permit Requ t(check box) 5/Re-roof(hurricane'nailed)(stripping old shingles) All construction debris will be taken to6"4 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. -Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not.exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. copy of the Home Improvement Contractors License&Construction Supervisors License is .; equired. SIGNATURE - Q:\WPFILES\FORMS\building permit formsUMIZESS.doc Revised 061313 05/31/2013 12.38 (FAX)5089875517 P.0017003 ACOJa ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMInruYYvp 0612312013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON-THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE P041CIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT;it the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. It SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights t4 the certificate holder In lieu of such andorsement(s). PRODUCER 01083•001 RRA;CT Oxford Insurance Agency 370 t108 987.0335 b08 987.0088 Oxxfford,tMA 0100 ' INSURED —Ibmga A, A.I.M.Mutual Insurance Company- SSraB Lmera Molinari JMBER 0' Molinari Home Improvement INSURER C: 11 Sheep Pasture Woy East Sandwich,MA 02d37 COVERAGES CERTIFICATE NUMBER, REVISION NUMBER: THIS 18 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CERTIFICATEINOTWITHSTANDING MAY BE ISSUED ORMAYEPEIRTAAIIN THE INSURANCENAFFORDED BY THE POLICIES OR HEREN IS SUBJECT TO TO ALL THE TERMMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ' l TYPE OF INSURANCE POLICY NUMBER M6IYYYY� LIMIT& DENERALLIABILITY RACHOCCURRENC6 COMMERCIALGENERALLIAEILRY M I 6 GIAIMa MApE OCCUR -MEMMOD EXP(Any One poism) S PERSONAL A AOV INJURY B GENERAL AGOREOATG ; EN'L AGGREGATE LIMIT APPLiF,a PER; PRODUCTS•COMPrOP AGG ; LICY O' OC AUTOMOBILE LIABILITY S ANY AUTO ALL OWNED SCHEDULED BODILY INJURY{per parson) ; AUTOS AUTOS BODILY INJURY(Per accident) ; HIRED AUTOS NON -O ED cciden S b UMBRELLALUI° OCCUR EACH OCCURRENCE S EXCESS LKS CLPJMSMADE - _ AGGREGATE ; _ DED 1 1 RETENTION II5 IUMM% � X Y NIA AWO-400-7000113.2013A 6121/2013 0/21/2014 E,L,EACHACCIIIE14T ; A ���, Pr.�Fst '�[d��IYa 100,000 (Mandatory In NH) E,L OISFrAUE.EA EMPLOYEE $ 100,000 6,L DI3EASE.POLICY LIMIT $ 600,000 DESCRIPTION OF OPERATION&I LOCATIONe1 YaXlet lS(A=oh ACORD 101.Additions,Rome tks&chedaie,it mom space is required) The workers compensation policy does not provide coverage for Libero Molinari I.CERTIFICATE HOLDER CANCELLATION Town of Barnstable 200 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCBLLEO BEFORE Hyannis,MA 02001 THE EXPIRATION DATE THEREOF NOTICE WILL BE D66NERED IN ACCORDANCE WTH THE POLICY PWAMONS., -. AUTHORIZED REPRESENTATIVE 8.2010 ACORD CORPO ghts reSerVed. ACORD 2e(a010/DS) The ACORD name and logo are registered marks of ACOND ., itf - r The CommonufeaUh ofMassachuseits Deparment of larbrshial Accidents Office ofl'nvestigatlons s 600 Mashington,S`treet f Boston,,MA 02111 wnhv.mass.gouldia Workers' Compensation Insurance Affidavit:Builders/Conti-actors/MectricianslPlumbers Applicant Information Please Print Legibly Name(I3usmesslOryanizafion&dividnal): AA o k I ki J)R f H Address: City/StateVzip: S Phone 4 619 1I5 Are you an employer?Check the appropriate box: T3,pe of project(required): ,� am s contractor an ❑ 1..�1 I/ 4_am a employer with � I t d I 6_ New construction e employees(full and/or pait4ime).* have hired the sub-ontractois. 2-❑ I am a sole proprietor or partner listed on the attached sheet 7- ❑Remodeling strip and bate no employees These sub-contractors have g_ ❑Demolition. working for me many capacity employees and have wodcers' 9- ❑Building addition [No workf`s, comp.insurance comp.tasurauml required- 5. ❑ We area corporati�and its lf#_.❑Electrical rf±pa or additions. 101 am a homeowner doing all work officers have exercised their 11..❑Plumbing repairs or additions myself[No workers'camp- right of exemption per MGL 12 El Roof repairs insurance required.]F c, 152, §1(4),and we have no employees-[No workers' 13.0 Other comp.insurance required.]; *Auy apphomt that checks boa*l must also fill out the section below showing their wo&era'compensadon policy iuE matim T Homeowners who submit this atddxm indicating they are doing 21l Traik and then hire oartside contractors nmst submit a new afdarit indlCatinF such lContractnrs that rheck this boar mast attached an additional sheet showing the name of the sob-o=tacuo-n anti state whether ornot those emities have employees. Irthe sat-cout moots have employees,they rmtst provide their Worker'comp.policy number. lam art employer that is prmliding workers'comperisahon irmiratice for my emp£nyeas helot`is the poUc}and job site information. Insurance Company Name: Policy g or Self--ins_Lie.4 .,.A wc. d d ? 1/3e 13 9 Expiration Date: 3/fit Job Site Address: /j_ , �L / A l i Y� n City"StatelZip: C,- Attach a copy of the workers'compensation policy declaration page(showing the policy number andd expiration date). Failure to secure coverage as required under Section 25A of MGL c, 152 can lead to the imposition ofrriminal penalties of a fine up to$I,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 tray against the violator. Be advised that a copy of this statement may be forwarded to the Office of Imirestigations of the DIA fDr inwrance,coverage verification. I do hereby certify render th/a/pruns andpenatties ofperjury thatth9 information prin ided above is truee and correct aienature: / 191 / Date: 1 / Phone 9: . J 6 a a-2 �V J' ©lWol use only. Do not unite in this area,to be completed by trity or town of`i'ciaL City or Town: Permit/License 9 Issuing Authority(circle one): 1.Board of Health 2.Budding Department 3.Cityffown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone t#: 6 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 hue, 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 Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth,`.or any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to y our situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their cerl.ficatc-(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 Indus'irial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. ne affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of t 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/licemse applications in any given year,need only submit one afridavit indicating current policy information(if necessary),and under"Job Site Address"the applicant should write"all locations III (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 oa 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 Ile 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 Xnvestigatians 600 Washington Street Boston„MA 02111 Tel.#617-727-4900 W 406 or 1-& MASWE Revised 4-24-07 Fax# 617-727-7749 W .mass-govfdia .. ;e agnmoorweer,lM o�C �tac7cc�eCly Officeof Consumer Affii'rs&i B"us►tiess Regulation s OME'IMPRO,VEMENT 66NTRACTOi2 egistration 102322 Type. xpiration: 014 DBA. MOLT ARI ROOFING' fit I iibero Molinari 11.SHEEP PASTURE WAY EAST SANDWICH, MA 0253T tij�adersecretar s g'.,. �9d�ss,achus�tt�-'Bcparta�iuit of Puhlic c BOMA of Builcli:nlg Re-tilatimis and Stand a cl ,' Cori`struction Supervisor :License License:,.,CS 40124, LIBERO J MO.LINARI 11 SHEEP PASTURE`WAY E.SANDWICH;,MAO253:7 v } Expiratian 3/29/2013 C i ut misvumi r•'' Tr# 126L18 ,� i . Licensee Details Demographic Information Full Name: LIBERO J MOLINARI Gender: Owner Name: License Address Information Address: Address 2: City: East Sandwich - State: MA ipcode: 02537 Country: United States License Information License No: CS-040124 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 3/1.8/2013 Issue Date: Expiration Date: 3/29/2015 License Status: Active Today's Date: 11/15/2013 Secondary License: Doing Business As: Status Change: Prerequisite Information No Prere uisite Information Disci line No Discipline Information Documentum http://elicense.chs.state.ma.us/Verification/Details.aspx?agency... 11/15/2013 073`0 Page No. i of Pages. NIOLINARI HOME IMPROVEMENTS 93 THORNTON DRIVE H t"ANNIS, MASSACHUSETTS 02601 Phone/Fax (508) $88-3750 Sandwich , r Phone/Fax.(508) 771•5266 Hyannis ]PROMOSAL "• PHONE DATE TO ? 50�3-77i- 2 84 1 ^"R DhA nr r� JOB NAME/LOCATION .-.;y... .- GREA 1 MARSH RD - CRNTE VILE , MA } JOB NUMBER JOB PHONE We hereby submit specifications and estimates for:. RE• ROOF ENTIRE ROOF } #i STRIP OFF EXISTING .ROOFING :2 INSTALL METAL r,I EDGE #3 . . INSTALL NEW VENT PIPE FLASH IN G #4 CHIMNEY CHECK ALL FLASHING AND . COUTER FLASH WHERE" NECESSARY 7 - #5 INSTALL SHINGLE UNDERL AYiENT AND ICE AldD UTATER SHIELD. WHERE NECESSARY. #6.. INSTALL � OR CERT 3O YEAR SHINGLES ( COLOR -mac #.7 . THOROUGH CLEAN UP OF ALL DEBRIS RELATING TO TriE;, ABOVE WORK #8' I.;STALL RIDGE VENTS , FILL IN OLD' VENT HOLES' WITH PL`� WOOD TEN YEAR WORKMANSHIP GUARAN,rEE LIMITED LIFE T;ME .WARRA.' ("Y ON SHINGLES � - FULLY '`INSJRLD. CCOKMNS N`" AND .I IAr�3T.LITY ?NSJ4Ai`JCE ,:y- ] 7 U W, �RIB hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: " . THOUSAND HUNDRED - . 1���0 ,G©. `�.. Payment to be made as follows: ONE HALF TO BE PAID UPON COMMENCEMENT OF THE ABOVE. WORK , . THE .3ALANCE TO BE PAID UPON COMPLETION , All material is guaranteed to be as specified. All work to be' Z completed in a professional manner according to standard practices. Any alteration or deviation from above'specifica- Authorized lions involving extra costs will be executed only upon written orders, and will become an Signature extra charge over and above the estimate..All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal maybe workers are fully covered by Worker's Compensation Insurance. withdrawn by us if not accepted within 30 DAYS days. AQ calpQffiD ce ®T IPTapoaml —The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified. Payment will be made as outlined above. Signature Date of Acceptance; Town of Barnstable $0 VVN 0 F t, [ir -) ,BLE �.�s" Regulatory Services y °� 20,913 AUG -4 PH 3' 2 f Thomas F.Geller,Director * BARNSrABM • 9 MASS . g Building Division 1639. '0tf0r A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 D I M S 10 N M Office: 508-862-4038 F 50•-790-6230 PERMIT# 6 5f 2 3 FEE: $ SHED REGISTRATION 120 square feet or less Location of shed(address) Village. Property owner's name Telephone number c/ Size of Shed Map/Parcel# ; Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) ' PLEASE NOTE: IF YOU ARE WITHIN THE JiTRISDICTION 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:121901 a� _ w �ii�� V � S � � � � . . . � ' ,X �� ! [' F `� k; � + t LOCATI OF PRO TY N E MA E ACCLJ R E STANDARD LEGEND NOTE:not all symbols will appear on a map GOLF COURSE FAIRWAY 230 ry""V-'✓-, EDGE OF DECIDUOUS TREES EDGE OF BRUSH ' ORCHARD OR NURSERY 18 V v P V EDGE OF CONIFEROUS TREES MARSH AREA — - EDGE OF WATER n 1 DIRT ROAD Mar 2 I 0 = DRIVEWAY E�PARKING LOT -PAVED ROAD 124s - ---- DRAINAGE DITCH # 39 / P 230 f ----- PATH/TRAIL PARCEL LINE** MAPtto F—MAP# # 21-<--PARCEL NUMBER #1660 -e HOUSE NUMBER 2 FOOT CONTOUR LINE 10 FOOT CONTOUR LINE Elevation based on NGVD29 �--- 4.9 SPOT ELEVATION fC=9=2= STONE WALL ' •IY*L%\?30 X X— FENCE RETAINING WALL RAIL ROAD TRACK Map 2 17-----— STONE JETTY # 2 SWIMMING POOL 1 PORCH/DECK i \ 22 1 (� 0 BUILDING/STRUCTURE DOCK/PIER HYDRANT e VALVE ® MANHOLE O POST pFP FLAG POLE T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N '1 T - a SIGN ® STORM DRAIN M PRINTED SCALE:IN FEET [National OTE:This mop is an enlargement of a **NOTE:The parcel lines are only graphic representation DATA SOURCES:Planimetrias(man-made features)were interpreted from 1995 aerial photographs by The James =100'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE a TOWER w Q 2Q 4Q Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimetria,topography,and vegetation were mapped to meet National Map Accuracy StandardsLIGHT POLE 0 EIfCfR1C BOX 1 INCH=40 FEET* arged scale. on the map. ate scale of 1"=100'. Parcel lines were digitized from FY2003 Town of Barnstable Assessors tax maps. F:\dgn\conservation.dgn 07/28/03 11:44:12 AM