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HomeMy WebLinkAbout0035 MASTHEAD LANE 3 i+K n 1 a , Application numb ............................................... 5 .�� Fee ....... ................................................ • P H E SM, I�Mof� HAM building Inspectors Initials..... ............. t63 Ak SEP 2 1 3L Date Issued...... .................... .. T EA.IN. O�bAKNS[Affl I ..............................Map/Part el......... ..... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: x. ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 3S M,J+4ce,) 4" Ce,."+Crv1,)1<— NUMBER , STREET VILLAGE Owner's Name: Phone Number S-Of--331-19'92- Email Address: -(�JOAfADAZ (P 5^-Ad, CO-: Cell Phone Number Project cost$ Check one Residential I-` Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize.'� -sd� to make application for a building permit in accordance with 780,CMR Owner Signature: f Date: C?/Z TYPE OF WORK. EI-Siding [B'Windows (no header change),#, 7 0 lnsulation/Weatherization Doors (no header change) # Commercial Doors require an inspector's review El Roof(not applying more than I layer of shingles) Construction Debris will be going to 6Ar^.r-&4k Tr44A(r J�"AbA CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable) # (attach copy) Construction Supervisor,'s License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN, A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER ............................................................ *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: to r r`1° Telephone Number S-v t- 3 3I- /9 9 2= Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction 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. Signature Date 912- /1r APPLICANT'S SIGNATURE Signature Date 9/1 All permit applications are subject to a building official's approval prior to issuance. t The Commonwealth of Massachusetts Department of Industrial Accidents -_ - Office of Investigations 600 Washington Street Boston,MA 02111 • www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): her, Address: City/State/Zip: A v 263z Phone Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full.and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7, ©'f emodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.2 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' 3.[�]Other 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 the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 3s- / �as7�r��� �.. City/State/Zip: Ccn"/ `ale 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 certify under the pains amend penalties of perjury that the information provided above is true and correct. Signature: 1-3,L= 1 Date: f/Z///f-- Phone#: s 4)r- 3 3I- l f 9 Z 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#: 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 s"an individual,partnership,association,corporation or other egal entity,or any two or more of the foregoing engagehn a joint enterprise,and including the legal representatives�f a deceased employer,or the receiver or trustee of an individual,partnership,association or other/Ithnor ntity,em oying employees. However the owner of a dwelling house having not more than three,apartments anresides herein,or the occupant of the dwelling house of another who employs persons to do maintenance, ction r repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because oemp oyment be deemed to be an employer." MGL chapter 152, §25C(6)all states that"every state or local licea ency shall withhold the issuance or renewal of a license or permit to operate a business or to construings in the commonwealth for any applicant who has not produced acceptable evidence of complianh the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commo nor any of its political subdivisions shall enter into any contract for the performance of public work until acceevidence of compliance with the insurance requirements of this chapter have been presented to the contracting y." Applicants Please fill out the workers' compensati,n affidavit completely, y checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)nam (s),address(es)and one number(s)along with their certificate(s)of insurance. Limited Liability Companies ELC)or Limited L' bility Partnerships(LLP)with no employees other than the members or partners,are not required;to Arry workers' co pensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affid vit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also a sure to sign and date the affidavit. The affidavit should %i�wia-iu?scu`?w��rd�� i? �•t7C�:�.l.w�-.�E;:C11..�-°.: LfY-=�-1-°`�J-�=�i ��—'��.�;4..'•.,:.-=� -.-.--� _ �. Industrial Accidents. Should you have any qu stions garding the law or if you are requii ed to obtain a workers' compensation policy,please call the Departme t at number listed below. Self-insured companies should enter their self-insurance license number on the appropriat lin . City or Town Officials Please be sure that the affidavit is complete and rinted legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event th OAe of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license num er whic will be used as a reference number. In addition,an applicant that must submit.multiple permit/license appl i ations in y given year,need only submit one affidavit indicating current policy information(if necessary)and under" ob Site Ad ess"the applicant should write"all location's in (city or town)."A copy of the affidavit that has beentofficially st ed or marked by the city or town may be provided to the applicant as proof that a valid affidavit is o file for future p units or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is ob ining a license or ermit 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 t thank you in advance fi r your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone an fax number: TAe Commonwealth of Ma achusetts Dkpartment of Industrial Accidents Office of Investigations 600 Washington.Street Boston,ILIA 0211.1 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#6.1.7-727-7749 Revised 4-24-07 www.mass.gov/dia s. Town. ._of Barnstable �0 THe rpm R o egulatory. Services T Thomas F.Geiler,Director - 1yl o9jJ -- MAfq. i6J9• Building Division �� �rFo►+�� Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstabl.e.ma.us. 0Mce: 508-862-403 8 Fax: 508-790-623(. PERMIT# a FEE: .SHED REGISTRATION 120 square feet or less r� - Location of shed (address) Village " k_0 Z Prope owner's name Telephone number ° r-. . - . rn . Size of Shed Map/Parcel# . S 3/Z /c2 9 Sign ture Date' / Hyannis Main Street Waterfront Historic District? V& - Old King's Highway Historic District Commission jurisd"ictionT' /Vy Conservation.Commission (signature is required) Sign off hours for Conservation 8:00-9.:30 &..3t304r30 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 Y YA Q-forms-shedreg . REV:042506. 1 �9 \ Yi C a a � T L� yy>> l 1. ix CEQ'CtF=t�.t_� pL.C7'T F-AY A.r 1 C tl lZ-CIF= Y Ti 14 A T- Y t-a U-- P-'L-A R t�t✓cl c ,l c_.C- �'�C WIT" 7r-4= °jlC�c t_�►-ice -- A�.It�� L�-rt,>ncK �'�qu►k'E:t�cir►_I-r�, mot"= -ra�t_-� �;_..,:.��� 'l3vju of r oFt To,,, Town of Barnstable do Regulatory Services avaysTABM y MASS. g Thomas F.Geiler,Director '�EnN,pr° Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 October 30, 2008 Benjamin S. Herrick 35 Masthead Ln. Centerville, Ma. 02632 RE: 35 Masthead Ln., Centerville, MA, Map193 Parcel 063 Dear Property Owner: It has come to the attention of this office that a shed was built on the above referenced property without the benefit of a shed registration as required by the Town of Barnstable. Additionally,the property is located in the RC Residential District which requires a ten foot setback from the rear and side property lines, and the shed appears to encroach into these setbacks. You are hereby ordered to bring the property into compliance or be subject to fines levied in the amount of no more than three hundred dollars per day for each.day the violation continues. Compliance may be obtained by: 1) Obtain a shed registration and move the shed to meet the required setbacks, or: 2) Remove the shed from the.property. Thank you for your anticipated cooperation in this matter. Please call (508) 862-4034 with any questions F By Order, 4rey . Lauzon Local Inspector Q:zoning5 pFTHE Tok, Town of Barnstable V� O Regulatory Services �,�"� * BARNSTABLE, y MAss. �, Thomas F.Geiler, Director )(1 iG3q• �� odd AlEDMA�A Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 September 30, 2008 Benjamin S. Herrick 6 Bluebird Ln. Nantucket, Ma. 02554 RE: 35 Masthead Ln., Centerville, MA, Map193 Parcel 063 Dear Property Owner: It has come to the attention of this office that a shed was built on the above referenced property without the benefit of a shed registration as required by the Town of Barnstable. Additionally, the property is located in the RC Residential District which requires a ten foot setback from the rear and side property lines, and the shed appears to encroach into these setbacks. You are hereby ordered to bring the property into compliance or be subject to fines levied in the amount of no more than three hundred dollars per day for each day the violation continues. Compliance may be obtained by: 1) Obtain a shed registration and move the shed to meet the required setbacks, or: 2) Remove the shed from the property. "Thank you for your anticipated cooperation in this matter. Please call(508) 862-4034 with any questions By Order, WreLauzon Locai Inspector Q:zoning5 YOU WISH TO.OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL,367 Main Street,Hyannis,-MA 02601 (Town Hall) K DATE: Fill in please: APOUCANT S YOUR.NAME: e94 cc W%r n BUSINESS YOUR HOME ADDRESS: 3s- ^aafA ear C. TELEPHONE # Home'Telephone Number Sok SG z Vc.zY NAIVj F NEW US1N S5- G y t . C'e i �. _ TYPE OF RI 1.SIN1=5S %r c� �t;;r,sr°� se r✓'c I$'f flS A:I ICIN1.IA tl]30. 1 RON: S � Ip, f lave yiiu b`eeii given.tipproval fr. wt (.the build n .cfJVisihh. YE.S,_NO . . t . . -- L N.UIRER,•.. 13— O 6 ,A3DR { Fgl5(N �S / p When starting anew business there are several 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 COMMIS ER'S OFFIC ti This individual b' n nfo f any it requirements that pertain to this type of business. MUST COMPLY WITH HOME OCCUPATION uthor' a S'gn re / RULES AND REGULATIONS. FAILURE TO COMMENT 2. BOARD OF HEALTH. This individual has been i med ofthWemit requirements that pertain to this type of business. Authorized Sin ure** COMMENTS: 3. CONSUMER-AFFAIRS [LICFNSNVG AUTHOYTY This individual has been farm,e1 f h I : e entsthat pertain to this type of business. Authorizedd(Siign�at re* COMMENTS: 1 Town of Barnstable (NE Regulatory Services F rp� o Thomas F.Geiler,Director • Building Division + BARNSPABLE, Tom Perry,Building Commissioner �A�fD MAC A 200 Main Street, Hyannis,MA 02601 m ww.town.barnstable.ma.us Office: 508-862-4038 ax• 5 $-790-6230 a Approved: Fee: Permit#: HOME OCCUPATION REGISTRAT ON Date: 10 %> Name: QoA�aa.r'n S. Hcrr ec E Phone#: ,I—o8' ' 9�G Z 802 S� Address: 3 Village: Name of Business: &o`- / f e ei ? . Type of Business: 1 r--c CL-4 t o Map/Lot: INTENT: It is the intent of this section to 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 carriecon by the permanent resident of a single family residential dwelling unit, located within that dwelling unit. • Such use occupies no more than 400 square feet of 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 Hcme 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 t 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 my home occupation I am registering. Applicant: /'5 ' S Date: Homeoc.doc Rev.5/30/03 Assessor's' map and lot,number .�a.....:kk.?-zr` C)/� /ec —3d--7 R ' SEPTIC SYSTEM MUST BE r . 1NSTA LLL6 IN -COMPLIANCE Permitnumber ...................................................:...... r 1�;1I i`i I ARTIr' E II STATE I HET� { S,ai`t A€�Y rOnE AND TOWN �o TOWN µ OF iBARN -x1=ABLE SAUSTA AE, i y w ti�. tit q �e�0 BU (LDING ; INSPECTOR APPLICATION FOR,PERMIT . , / L ......... .. TYPE OF CaNSTRUCTION .. .. .................... i z ..................�..vf�l .....19 . TO THE INSPECTOR OF BUILDINGS: The undersigned h reby applies for a permit according to the following information: Location :.. .....X�v., :............ ...........�.. . .............. ................................... Proposed Use .. . . ... ..... . . . .............................................................. ... . .... .. . ... .. ... .... 4 Zoning District ............................ ......... . ...... Nameof Owner ...........: .. ....... J:........Address ........ . .... ..............:.................................................. Name of Builder .........................................................:..........Address ........... Nameof Architect .................................................:................Address .................................................................................... Number of Rooms .............. .. Foundation .......1.......... �. Exierior 40/ �� �i ...............Roofing ...... 5� ...�7:� Floors .............!!Vi...4.�....1...........................................Interior ........ Heating ........l..,r.. h� ..K/,t.. f�....:Y.!.: .:.......................Plumbing -.;�... Fireplace ...........6 ...................................................Approximate Cost ...... .�r.................................................. Definitive Plan Approved by Planning Board --------------------------------19--------. Area .... .. /. .................. Diagram of Lot and Building with Dimensions Fee ..y ....................... 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 ..... .................................... � Capewide Development one story ` ' single family dwelling —�.---------.--.�--_----�..----- ' ' 35 Masthead Lone ' - location _---------..--.--------- , ` . ~ . . Centerville � —~.-----.-.------_—~--..--...--.` - � . ' emn��e Development . , ^ ` Owner ..---.���������,-- �� � ��..--. Typo of Construction .,--�����.----. —.-- . . . . . ` ..........- ' ^ ` #27 Pkx. . .. . .. Lot ................................ ' ' ^~ ' ^ . �� 7B �ermh Gronmy� '.. ���� ..lg ' � , ~ —'... � . | � ,bate of Inspection ..1P ' ' . 'ate Completed ...... ^ —..—lV . . . , PERMIT REFUSED ` . .-. ` ^ - - lV--.--~--.—..,..—.--.--.--.—.. . � . - . . . ' . ` ----'..---,-._—.-----.----.---.-- . . . . ^ —.._....`^._...��...,_...�_—~~..—~'`--.. - . ' -^...`—,--,...-_....-.~.-.,,..—.--~-~...... �....��.�'.�������....����.���.�..�.. . - . . ' ! /- .................................. -- 19 -._--..---------.--.--,....-.'.~-, . ^ . - ' ----'---------'—''—^'~^'--^^^^^`~~' . . ` | ` ' ' -- 33 + c s "Z.� b t5,&'Z8 SF A vv ate,,. �3 'b_ATG'= T"AT T(4c-- J�hCtQi.! 5t-law►J I LA►J R�F�tL��.1GE 4-IEQErst.� GCOAPI.I-IS W►TN TI-IG - AWE> 5ET$nCiG VGQUIcZEME"TS O. -TO W tJ OF DATE t C' �• RC.GIS CC-_i:i�.D 1.�..1•.tC� �l)�'_e1�V� . uo•r ISASE'[o U+.1 A�J OSTEI~�/tt_t� a A,CASS. It.l jt-[ZU�.�IrtJ l 6uZ\jv=-( t T,.AC UF1='eTle, S�1G!�JCA fl�i"►l_i Gla.1`!T � ff t3L- u,ec) Tc, uen re.L-M iWO= LoT• Lt1-4e � ��►'� �'l '- � _