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0049 NATKA DRIVE
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P 0 M ¢ 'c a S) O .v t' e o G o t. r _ i 13 P n >„ { k . n 5 }J,, 3 £ :1 a U .a,, . a AI , 'fit Town of Barnstable Buildl . . . ng 'Post This Card So That it is Visible:From the Street Approved Plans Must be Retainetl,on Job and this Card Must be Kept AMAS& $ Posted Until Final Inspection Has Been Made Pey.1111t Where a Certi cate of Occu anc 'is Re u�red,such Buildm shall Ndf be Occu ied'u p Permit !.s p y q :. g p ntil a Final Inspection has been made Permit No. B-18-2722 Applicant Name: STEPHEN DUFF Approvals Date issued: 08/22/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/22/2019 Foundation: Location: 49 NATKA DRIVE,CENTERVILLE Map/Lot: 169-117 Zoning District: •RC Sheathing: Owner on Record: MACKAY, MIKE J Contractor'Name:- :JOSEPH A RENNIE Framing: 1 Address: 49 NATKA DR Contractor:License:: CS=086728 2 CENTERVILLE, MA 02632: Est. Project Cost: $7,000.00 Chimney: Description: RE-ROOF STRIPPING OLD Perrmt Fe'e: $35.70 Insulation: Project Review Req: Fee Paid:; $35.70 Date. 8/22/2018 Final: i Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: ii'This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after,issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and`the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures'shail be in compliance with the local zoning by-laws and codes. Final Gas: This.permit shall be displayed in a location clearly visible from access street or roadand shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical. The Certificate of Occupancy will not be issued until all applicable signature's by the Building and'Fire Officials are`provided on this`permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector approved the various stages es of construction. Final. _ "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT e i a� as afr Application number... .... .................... Date Issued................ L: ..�. .. KAM: ems � :. � Building Inspectors Initials........... . ...................... Ak Map/Parcel....l. ."l ............................................ OWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: A) Tt-"9 �),C, t!3enC&4xe-& NUMBER STREET VILLAGE Owner's Name: Phone Number Email Address: Cell Phone Number Project cost $ �4 Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK ❑ Siding ❑ Windows (no header change)# ❑ Insulation/Weatherization ❑ Doors (no header change)# Commercial Doors require an inspector's review ET Roof(not applying more than 1 layer of shingles) Construction Debris will be going to Y°�r^�2,rzytyh CONTRACTOR'S INFORMATION Contractor's name���TF®/-� Home Improvement Contractors Registration(if applicable)# % 6 d (attach copy) Construction Supervisor's License# -�� [� (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 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 ............................................................ T. -� *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 tenff dimensions can be attached on a separate piece of paper. 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: Telephone Number 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 APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of IndustrialAccidents - 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): Address: 16L7 ,14 6C. /ne V City/State/Zip: <'� Phone#: ( C� Are you an employer?Check the appropriate box: Type of project(required): l.❑ I am a employer with 4. �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. ❑Remodeling ship and have no employees ' , These sub-contractors have g; ❑Demolition workingfor me in an capacity. employees and have workers' Y P tS'• $ 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 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 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. 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-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: 4 � Policy#or Self-ins.Lic. Expiration Date: la l Job Site Address: �rG'.�f�a City/State/Zip: ��U'Vi 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 and penalties of perjury that the information provided above is true and correct Signature: G Date: Phone#: 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#: 4 Information and Instru tions Massachusetts General Laws chapter 152 requires all employers to provide worke s' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service another under any contract of hire, express or implied,oral or written." An emplo r is defined as"an individual,partnership,association,corporation other legal entity,or any two or more of the foreg ' g engaged in a joint enterprise,and including the legal represen ves of a deceased employer,or the receiver or tee of an individual,partnership,association or other legal enti ,employing employees. However the owner of a dwe ing house having not more than thiee apartments and who re des therein,or the occupant of the dwelling house o other who employs persons to do maintenance,contra 'on or repair work on such dwelling house or on the grounds o building appurtenant thereto shall not because of such ployment be deemed to be an employer." MGL chapter 152, §25 6)also states that"every state or local licensin agency shall withhold the issuance or renewal of a license or p rmit to operate a business or to construct b ildings in the commonwealth for any applicant who has not pro need acceptable evidence of compliance 'th the insurance coverage required." Additionally,MGL chapter 1 , §25C(7)states"Neither the common w alth nor any of its political subdivisions shall enter into any contract for the p ormance of public work until accep ble evidence of compliance with the insurance requirements of this chapter have een presented to the contracting a ority." Applicants Please fill out the workers' compensation ffidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and pho a number(s)along with their certificates)of insurance. Limited Liability Companies(LL or Limited Liab' ity Partnerships(LLP)with no employees other than the members or partners,are not required to cant'w kers' compe ation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that th affidavit ay be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. A o be s re to sign and date the affidavit. The affidavit should be returned to the city or town that the application for a it or license is being requested,not the Department of Industrial Accidents. Should you have any questions regar ' g the law or if you are required to obtain a workers' compensation policy,please call the Department at the num a isted 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 1 gibly. Th\hn ent has provided a space at the bottom of the affidavit for you to fill out in the event the Office f Investigha to contact you regarding the applicant. Please be sure to fill in the permit/license number whic will be use ref rice number. In addition,an applicant that must submit multiple permit/license applications' any given yeed o submit one affidavit indicating current policy information(if necessary)and under"Job Site ddress"the ant shou write"all locations in (city or town)."A copy of the affidavit that has been official) stamped or by the ci r town may be provided to the applicant as proof that a valid affidavit is on file for ture permits nses. A new a davit must be filled out each year.Where.a home owner or citizen is obtaining a li ense or permelated to any b ess or commercial venture (i.e.a dog license or permit to burn leaves etc.)said erson is NOTed to complete this ffidavit. The Office of Investigations would like to thank yo in advance forcooperation and should ou have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax numb r: The Co onwealth of Massachusetts Departm t of Industrial Accidents O ce of Investigations 600 Washington.Street oston,MA 02111 Tel.#617-727-4�00 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia RENNIEJ002 MWOLF ACORD' CERTIFICATE OF LIABILITY INSURANCE DATE 04/17/2018Y) 04/1712018 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 POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If 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 to the certificate holder in lieu of such endorsement(s). PRODUCER License#1780862 C EACT HUB International New England PHONE FAX 600 Longwater Drive (A/C,No,Ext):(781)792-3200 (A/C,No):(781)792-3400 Norwell,MA 02061-9146 E-MAIE INSURERS AFFORDING COVERAGE NAIC# INSURER A:Associated Industries Insurance Company,Inc. 23140 INSURED INSURER B: Joseph A.Rennie INSURERC: 4 Wayside Lane INSURER D: Sandwich,MA 02563 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 7 OCCUR DAMAGE TO RENTED PRE MI E Eaoccu e $ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PEPT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accide $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS SSWN BODILY INJURY Per accident $ AUTOS ONLY AUTOS ONLY PPe�acEciRdent AMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I RETENTION$ A WORKERS COMPENSATION YIN CC5005018295 01/26/2018 01/26/2019 PTRT OTH- AND EMPLOYERS'LIABILITY 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ KFICER/MEMBER EXCLUDED? ❑N N/A andatory In NH) E.L.DISEASE-EA EMPLOYE $ - 100,000 If es,describe under - 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Wareham THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 54 Marion Rd Wareham,MA 02571 AUTHORIZED REPRESENTATIVE LJ�IJ�YI/�-1- ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD STEPHEN DUFF Gustomer: GONSTRUGMON LLC. 30 Address: 1580 YEAP5 BARNSTABLE t- IA.02030 EX9. .5o8-�roa-27o7 Telep one: ^�( SADUFFGO@YAHOO.COM Date: Z '2-b For The Amount Of 4- 1 Gil our -e L ( I64 / vv lyres !/I fp�C a Payment Schedule: Af Stephen Duff Date Customer Dote Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 "'° Boston, Massachusetts 021.18 N , Home Improvemen. ; o tractor Registration Type: Corporation °J A Registration: 188860 STEPHEN DUFF CONSTRUCTION,LLC `i � I � Expiration: 09/11/2019 U 1. 1586 HYANNIS RD '� BARNSTABLE, MA 02630 c ` y,.i.� d 4.,.=.L IN "�—.J �_6 2N ° co uj Update Address and Return Card. c ° a . 1 Z Q�Q SCA 1 20M-05/17 - E m m U Q C1 C) O =N U m N w Q z E Office of Consumer Affairs&Business Regulation o 1— Q HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only co 'to a N o TYPE:Corporation before the expiration date. If found return to: o U Renistratioh Expiration Office of Consumer Affairs and Business Regulation ,<� U 1.88860-- 09/11/2019 1000 Washington Street-Suite 710 STEPHEN DUFF CO ST.R C ION,LLC Boston,MA 02118 �'J x STEPHEN DUFFt-,1586 HYANNIS BARNSTABLELE,MA 026 Undersecretary Not valid without signature AR30' a.ln;euft InO Inn pllen IoN fuL"ejoesiapun B992:0 VVY'HDIMONVS N-1 301S kvM b J G t 31NN38 Hd3SOf 80LZ0 bW`uo;soe, LOEL apnS-aoeld uojjn �t °.31NN31i Hd3SOf uoguin6atl ssaulsn q4�d au0 02:0 L/90 - t3 j 11 s�le�lb'�awnsuo0;o 80.40 Zb66S 1 :o;wn;aj puno;;l a;ep uol;e�ldxa 843 ajo;aq uol;eel x3 uo-Wi sl as Aluo asn lenpinlpui Jo;pileA uol;ej;sl5ay Ienp!A!pul:38A1 8010V•81NOO 1N3 W3AO8cjWI 3WOH uoizelnBeEl ssau!sne$s ie yjawnsuo0;o aaigo _ �a���ya�nuouizc�o er TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 6 Parcel I MP nc BARNSTABLE Application # 2�6 15 b H l �� Health Division o- s, ; Date Issued '� �(0 1 Conservation Division v Application Fee 5-6• D nn Planning Dept. Permit Fee V�,/ Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 41 gri kh Z Village Ce n 4-e r w l I e Owner ('n 1,arc (,)kc L Address s a,rn G Telephone T I LI 5 on, b� i h Permit Request r"t1 A R- 1 Y aa� R-30 cell-A l os G JI Q - 6 4;f� C. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ 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 iCentral Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes .2(No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDDER OR HOMEOWNER) - - Name w,1 i, m I'►c c 1v ke,, � e S aVG .!I►c._._ Telephone Number 608 3 q8 03 96 It I Address 7-) H-kn �.nc-�n Pt License # T c l om- S Y_arM o%A . 1 % b� 4 Home Improvement Contractor# Email Worker's Compensation # W C 3136a� I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE 6 1 y 'v FOR OFFICIAL USE ONLY Q " APPLICATION# a DATE ISSUED MAP/PARCEL NO. v cT ADDRESS VILLAGE 4 ? OWNER DATE OF INSPECTION: t FOUNDATION FRAME ti INSULATION I> FIREPLACE ELECTRICAL: ROUGH FINAL x I.i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I M /\� C DATA a HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. F a hereby consent to.and agree that weatherization work may be done by the Weathdrization Program of Housing Assistance Corporation on the property located at: ; f The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping; air sealing; attic&basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. 1 give permission to Housing Assistance Corporation the property with such equipment and materials a!`may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this agreement and give my consent. Home Owner(signature) Home Owner email: Date: U Agent:(signature) fJ3; `�" _ rl Date: f, Weatherization Contractors: Adam T Inc Cape Save All Cape Energy nergy Solutions. Alternative Weatherization Lohr Home Improvement Building Science Construction Resolution Energy Cape Cod Insulation Tupper Construction The Commonwealth of Massachusetts - Department ofIndustralAccidents C - I Congress Street,Suite 1.00 < Boston,MA 021I4-2617 , www mass.gov/dia 1N'orkers'Compensation Insurance Affidavit:Builders/Contractors/Electrieians/-Plumbers. TO BE FHXD WITH THE PERMITTING AUTHORITY. Applicant Information _. Please Print Leliiibly Name (Business/Organization/Individual):Cape Save Inc .Address:7-D Huntington Avenue City/State/Zip:South Yarmouth, MA 02664 Phone#:508-398-0398 Are you an employer?Check the appropriate boz: _ Type of project(required): 1.[D I am a employer with 20 employees(fulland/or part-time).' 7. ,❑New.construction 2. am a soe proprietor or partnership and have no employees'working":for me in ❑I l 8.i Ej Remodeling any capacity.[No workers'comp.insurance required.] 3F�I am a homeowner doing all work myself.[No workers comp.insurance required.]t 9. El Demolition- - 10 'Building addition 4.❑,I am.a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have.workers compensation insurance or are sole I1 []Electrical repairs or additions ❑proprietors.withwith no employees. 12.❑Plumbing repairs or additions 5 Tam se sub=contractors haeneral contractorve employeesd 1have red the and have workers's'*omp insuurancectdrs listed on the attacfiedsheet. ' 13Roof repairs 6.n We are a corporation and its officers have exercised:their right of exemption per MGL c:' 14.[a Other .Insulation -- 152,§1(4),and we have:uo employees.[No workers'comp.insurance required.) *Any applicant that checks box#1 must also fill out the section below shoeing 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 isthe policy and job:site information. Insurance Company Name:Wesco Insurance.Company , Policy#or Self-ins.Lid.#:WWQ3136274 Expiration Date:04/09/2016 Job Site Address: 49 Natka Drive' City/State/zip: Centerville 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 up to$1„500.0:0 and/or one-year imprisonment,as well:Is 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 stitement maybe forwarded to the Office of.Investigations.of the DIA for insurance coverage verification. I do hereby certify under th pains and:penaltes of perjury that the informatou.provided above is true and:correct Date: Si attire:. ' Phone#:508-398-0398 Official use only. Do:not write in'this area,to.be completed by city or town official City or:Town; Fermiflhicense# Issuing Authority(circle one): L.Board of Health. 2.Building Department 3.City/Town Clerk 4.Electrical..Inspector 5.Plumbinm.inmector- 0.Other. Contact Person:.." Phorie#: . AC�� DATE(MMIDDIYYI^r7 �,,,... CERTIFICATE OF LUP; ILITI( IfVSURANCE �/24/2Q15 THIS CERTIFICATE IS ISSUED AS A M. ATTER OF INFORMATION ONLY•AND;CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELlf'AMEND, EXTEND OR ALTER THE COVERAGE;AFFORDED.BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETVWEEN THE ISSUING.INSURER(S)' AUTHORIZED REPRESENTATIVE OR PRODUCER,ANDTHE:CERTIRCATE.HOLDER JMPO,RTANT: If the certificate hoiden is an ADDITIONAL INSURED,the poiicy(les)rrius4 be endorsed. 4 SUBROflk-nom i5 WAIVEA- subject to the teens and conditions of the policy;certain:poficies may require an endorsement. A statement on this certificate does not eonferrights to the certificate holder In Lieu of.such endorsement PRooucER NAME: Colleen Crowley Risk Strategies :o. many PHONE (781)986=4400 F!C W.(781)963-4920 15 Pacel]3 Park Drive ApMgss.ecrowiey@;Z k- rateg es.com Suite 240:<. I:tasttwlph - INSURE S AFFORDING COVERAGE NAIC* _ rMA Q2;3S8 wsURMA:Seleetive 'Ins. oP America INSURED .:. INSURERSAAI]mazica E'i:3]iaACia1 A11lanCe 0212 Cape Save, IaC _ INSURERC.Wesco =nsurance, C an 7 D Huntington Ave INSURER D INWRERE. south Ymeuh` a26�4 _ INSURERF. COVERAGES' CERTIFICATE Nt1MBER:CL1532491501 REVISION NUMBER: L 41S IS TO�-RT1FY TWAT Tf'If+oLiCiES Of INSURANCE 11STED QEtOW HAS BEEN ISSUED.TO TH INS(5RE0"MMED AieMOVE TOR`T1�E'I110Lf0Y'PERTOB` INDICATED. NOTWITHSTANDING ANY REQUIRE MENT,TERM OR CONDI710N'OF ANY>CONTRACT OR OTHER DOC1yMETIT:WITH RESPECT TO ViMICH THIS ERTIFICATE MAY BE`ISSUED'OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED.:HEREIN IS SUBJECT TO ALL THE TERMS, XCLUSIONS AND CONDITIONS qF SUCH;POLICIES.LIMrrS'SHOWN MAY HAVE BEEN REDUCED BY PAID:CLAiMS. TYPE OrINSURANCE AOOLS OLD;EF P0�ICY EXP- LIMITS POLICY'NUVIBER GENERAL LIABILTY EACH OCCURRENCE' $ 1;000,000 X. COMMERCIA GENERAL LIABILITY G PRE ISES Ea oxurrence $ 100,000 A CLAIMS-MADE �X OCCUR 1994480 0/16/2014 0/16/20j5 M�EXP I�yone person) $' 10;000 PERSONpi&ADV fN LL Y s ' 1,'000,QOO GENERAL AGGREGATE $ 2j000,000 GE ZAGGREGATE LIMIT APPLIES PER PRODUCT$-COMP/OP AGG $ 2,000,000 P00CY X PRO- X..LOG ALIToraloBiLE:LIaelLrrYSINGLETUIT 1,000,060, $ ANY RUTO BODILY INJURY(Per person) $ AUTOS:.:E RSUCTOE ULF� 46796600 1/6/202Q. 1/S/2015 BODILYINJURY(Per accl.d $ X HIRED AUTOS• X NOAJ 01J4P1ED Rt9PE tTY DAtNAGE AUTOS: Pes $ X UMBRELLA LIAB>' X AGCUR EACH OCCURRENCE $ 1,600,00 0 EXCESS LIAR CLAIN75avlADE AGGREGATE $ 1,000,000 DED RETENTION 61 1994480 0/16/2014 0/7572015 C WQRK9WQMF1NSAitON $ AND EMPLOYERS'LIABILITY YIN f f£SapAYs Ihc]ttr�ed for X vie sTATtr rRH_ ANY PROPRIEiORJPARTNER/E)fECUTIVE Overage OFRCEPJMEMBER OCCLUDED? N, NIA E L.EACH ACCIDENT $ 500 OOO (Mands&q In NHi �3fi274 /9/201'5` /9/2016 1f yy0es,describe under i E>L.DSSEASE-EA EIviFEOYE $, .500 001D DESCRIPTION;OF OPERATIONS below EL.DISEASE.-POLICY LIMIT $'` 500 000 'DESCRIPTION CF OPERATIONS[LOCATIONS I VEHICLES(Attach%40RD 109,Additional Remarks;Schedufe,if raoro space is requSred) Issued as evidence of insurance.'. Thielseh Engineering, .Inc. is listed as additional insured:;as respects: General Liabilaty' as sequyrer3 by vtsitl`en soaxtrct. CERTIFICATE#MOLDER CANCELLATION msongLa Cagel � # � SHOULD ANY DF THE,ABOVE DLSCitIsEDI�'OLIOIet BE C/4"I'>CELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cage Fight COIIIp3C AGGORDANCE WITH THE'P+OLICY PROVISIONS. 1. Attn:LL, Margaret sos><g... . .. .: . G �oG 427/SCIi. AUTHORIZED REPRESENTAT PIE 3195: Main Street Barnstabler. D2630 ACORt7°2;3(20i01Q5aI,9MRO 1 U&poRA'� k, AH Figtrte reserved, INS o25(zotoos).o� The ACORD name and,Togo are registered marks of ACORQ �_. dkz �Ile / % P M. Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C6ritractor Registration Registration: 171380 Type: Corporation F` Expiration: 3/14/2016 Tr# 249649 lwei CAPE SAVE INC. ' WILLIAM McCLUSKEY A '' 7-D HUNTINGTON AVENUE - SOUTH YARMOUTH, MA 02664 % —=---- --- Update Address and return card.Mark reason for change. 0 Address [3 Renewal Employment Lost Card SCA 1 Q 20M-05/11 ?Ti `�rriri�cfruuetcl,C�refr?l��ft�•rcrj�a��/ -,___._,. 4N". Office of Consumer Affairs&Business Regulation License or registration valid for individul use only A OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 171380 Type: Office of Consumer Affairs and Business Regulation Expiration /2016 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE SAVE INC. k WILLIAM MCCLUSKEY =1 z 7-D HUNTINGTON AVE." SOUTH YARMOUTH, MA 02664 Undersecretary Not vali fthout signature Massachusetts -Department 6 Public Safety , Board of.$uiiding Regulations and.Standards License CSSL-102776 t ti • .� r1s WILLIAM J MCU. 37 NAUSET ROAiD !� West Yarmouth MA Commissioner :061281201:7 . Cape Save Inc. o L 8/31 s 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax:•508-398-0399 7/31/15 :> Town of Barnstable ' ' Thomas Perry CBO - Building Commissioner 200 Main St.Hyannis,MA 02601 RE: Building Permit#201504103 z TO: Building Inspector(s), , This affidavit is to certify that all work completed for#9 Natka Drive, Centerville has been -. inspected by a third party Certified Building Performance Institute(BPI)Inspector. :, , All work performed meets or exceeds Federal and State Requirements. j Sincerely, ,. William McCluskey, Y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION k�J Map Parcel Application # Health Division Date Issued 3 0 Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation / Hyannis Project Street Address _ - \ fu k a, 12) 0— Village Le n, ee r("r I [Q Owner a<Q Address Telephone Permit Request —'ri J,0_� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Q Groundwater Overlay Project Valuation Z o Construction Type_�sLtta�1�� a 5 rV� Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ 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 garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:z Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ j: 4_7) w.- 0 Commercial ❑Yes ❑ No If yes, site plan review# a ',Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - --- Name `J � �'��► ��� y� Telephone Number ,'��S-- F-a-,5_33 Address 2:Z 0-V License # O Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE _ DATE `? 4 FOR OFFICIAL USE ONLY } APPLICATION# e DATE ISSUED 1 .k MAP/PARCEL NO. ADDRESS ' VILLAGE OWNER r' DATE OF INSPECTION: FOUNDATION 317-4I11 ('Xow• FRAME r INSULATION FIREPLACE �r ELECTRICAL: ROUGH FINAL' I PLUMBING: ROUGH FINAL GAS: ROUGH FINAL R FINAL BUILDING F y ` DATE CLOSED'OUT t ' r ASSOCIATION PLAN NO. The Commonwealth of Massachusetts r ' Department of Industrial Accidents ^�4I;; i:d Office of Investigations L.!� r 600 Washington Street j Boston, MA 02111 _ ww .mass ov dza r , w / Workers' Compensation Insurance Affidavit:=Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual); Q �GL1t/ /t+ C., Address: - Z'Z.) w { LQ City/State/Zip: 6rQ _S- Y e—c.; O'?%6 3 ( Phone #: Are you an employer? Check the appropriate box: Type of project(required)`.? 1.❑ I am a employer with .4. ❑ Lam a general contractor and I • 6. New construction employees(full and/or part-time),* have hired the sub-contractors 2.El am a sole proprietor or partner- listed'on the attached sheet. $ ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑.Demolition 3 workingfor me in an capacity. workers' comp. insurance. Y P h'• 9. ❑ Building addition , [No workers' comp. insurance 5. We are a corporation and its required.] officers have exercised their 10.❑,Electrical repairs or additions 3.❑ 1 am a homeowner doing All work right of exemption per MGL I I.❑ Plumbing_repairs or additions myself. [No workers' comp. c. 152, §](4), and.we have no 12,❑Roof repairs insurance required.] t employees. [No workers' comp, insurance required.] 13.❑ Other' ' *Any applicant 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 submitanew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their.workers'comp.policy_information.: I am an employer that is providing workers'compensation insurance for my employees. Below is the policy dndjob site information. Insurance Company Name: Policy#or Self-ins. Lie. #: Expiration Date:. . Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and,expiration date). Failure to secure coverage as required under Section 25A;of MGL 6'.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 maybe forwarded to the Office of Investigations.of the DIA for insurance coverage verification, , I do hereby certif d th ains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 1 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 as"an in 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 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 1P2, §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 your situation and, if necessary,supply sub-con actor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liabili 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 permit/license 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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a 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 0211.1 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 t www.mass.gov/dia .. • L99L •#Ji iaunissnuuio� IaOZ./6Z/lL ,uoiendx3 6£9zo dW '83J_SM3813 di•!1-1I1-1 NnH LZZ HJ f1W3NN3H _0 A38dJ3f 00 :ol paiautsay ~lObZb so :asuaji� t i T as ua31,1 JosiAladnS uol;onj;suo0 sp i;purls pur. sutiilMA r.lopd �uipltng to par.01111 ;a t>S ,)ilgnd I }o luaw)�-nilad =s3��tiny�rtitirW -� ✓fi h� Office of Consumer Affairs 3r Business Regulation.' " License or registration valid for indrvidul use only t''f HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration .9*106821 Type: Office of Consumer Affairs and Business Regulatiow Expiration:, 7/27/2012 ;' Private Corporatio 10"Park Plaza-.Suite 5170 4 Boston,MA 02116 D MAN INd. Jeffrey Hennemuth` n '� 3 N /227 Run Hill Rd ti Brewster, MA 02631 Undersecretary Not vAlid without signature - f� Towne. of Barn-stable Regulatory Services tARN5TA8LE, vs Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner F 200 Main Street, Hyannis, MA-02601 wwy%.town.barnstable:ma.us office: 508-862-4038 Fax: 508-790-6230 Property Qvmer Mush Complete and Sign This 'Section,. If•Using A Builder as Dwner of the subject pro e R _ , -hereby authorize . e�m ,e A ` A,'I to act on my ea bhlf , in all matters relative to work authorized by this building permit applicatiori for. � ;-Ica— or\ (Address of rob) I1 - Signature of Owner 'Date Pnnt Name If Property Owner is applying for permit pleas e complete the Homeowners License Exemption Form on the reverse side. • Town of Barnstable C, 'I HE ray Regulatory,Services S`rAB Thomas F. Geiler,Director ' Building Division PrfD �a Tom Perry, Building Commissioner 200 Main.Street, Hyannis, MA.02661 R,wv.to wn.b arnstabl e.ma.us Office: 508-862-403 8 Fax: 508-790-6230 ETOI%E0WNER LICENSE EXEMTTION Please Print DATE: JOB LOCATION: number s treet village "HOMEOWNER": name home phon.c# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as su'pervisor. DEFINITION OF HOMEOWNER Persons) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to,the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned "homeowner"certifies that.be/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and rUlUirements. Signature of Homeowner Approval of Building Official Note: T2iree-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section,(Sccdcin 109.1.1 -Licensing of construction Supenzsors);provided that if the homeowner engages a person(s)for hire to do such work,•that such Homeowner shall act as supervisor." )4any homeowners who use this exemption arc unaware that they arc assuming the responsibilities of a supervisor(sec Appendix Q, Rules&Regu)ations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homrowncr hires unlicensed persons. In this case,our Board cannot procccd against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. —. resloonsibilitiu,many communities require,as part of the permit application, To ensure that the homeowner is fatly aware of his/her that the homeowner certify that he/she understands the responnbilitics of a Supervisor. On the Iasi page of this issue is a form currently used by several towns. You may care t amend and adopt such a forn/ccrtification for use in your community, - - r - ' - �_._ -..��. ..- - -_ - -_ _�" � _/♦. ��/��,�T/mow � m �// JE 7- 1 srA "Lac.-7G-r,> JAMS : 0. �l/ *, y�.... ..�.,..... ..;_..- Tt.�. �. � �..�.rt � �� }�.� 1 �1. _.—...�.--__.�F.__: 11...�p Co , IF 4 IY Pipe �_ sue... .I" — — • �� {-- �9 +_wrrell� � Y y II iA, ►�(` ; rn , , + +- + , Ft- r I � � 3 t { k -- 1 -I I I -y i i r4 M r � i� a I I 1 , � t o L9* S C.C. 97 i AA q a r 1 1 !JI JA L a � 4 , �I t _ f E ' I P , �' - If P __a 4 I + Town of Barnstable" Regulatory Services oFIMe Thomas F.Geiler,Director Building Division snMsrnsi e, : Tom Perry,Building Commissioner 9 HAM. g cb 1639. .200 Main_Street,Hyannis,MA 02601 CFO MA'S A R Office: 508-862-4038 Fax: 508-790-6230 September 29, 2011 i Jeffrey Hennemuth 227 Run Hill Rd. Brewster, Ma. 02631 RE: 49 Natka Dr., Centerville Map: 169 Parcel: 117 Dear Mr. Hennemuth: This letter is to notify you that a final inspection was conducted at the above referenced address and the following deficiencies were found: 1) Ledger needs additional attachment support to existing house. 2) Joists need lateral support and uplift resistance at girder: Please resolve these issues immediately and arrange for a reinspection. Be advised that failure to fulfill your obligations as construction supervisor may result in this office to take additional action. Respectfully, J L Lauzon Local Inspector (508) 862-4034 - oFVEr The Town of Barnstable do Department of Health, Safety and Environmental Services BARNSTAB14 " Building Division � 1639. ,0�' 367 Main Street,Hyannis MA 02601 ArFO MA'S A Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration 3�� 95 Date: �" 1 Name: Sco �C ��i �9. Phone#: 1 _(e 3 3 S f Address: Village: Type of Business: (2E v,.e.4J u G's"_ L-,P_A Map/Lot:_ 1 L 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 carried on 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 Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Date: Homeoc.doc �19WET , The Town of Barnstable Department of Health, Safety and Environmental Services t�►trtsrAera.. s Building Division NLAM �► 1639. 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Daze: L/- /"� �111-17 Name: 1 Phone #: ' `712 Address Village. C P.y U���P� Type of Business: Ca'In, ti 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 alieration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies 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 Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read jande. ve restrictions for my home occupation I am registering Date: Applicant �%e'•r�eaC"r-n.��s•��". _.i7:�r"�1"y6'�'""'@�,a7�'T�''."d'^�`�{*+4��-.��.,.:.�..,�A.•.gfi.`'.{�icsT#,� i ��1'"bi�J.c�:;7�F"9,it�if..��.wirTM.wr♦.�, '.It�%"i"¢'"c'Y.�'r"``„� F9"�'7fn`"r'i'wr.+�:1Fgtir k�+ '7Y'�;'�'y'r"[a+e'�fl:Syr_,e�w�.i.n+.. ,�TME TOWN OF BARNSTABLE Permit No. 31889 •` BUILDING DEPARTMENT a.aan TOWN OFFICE BUILDING Cash .bso• . 9'�taor HYANNIS,MASS.02601 Bond ......sx... .. .. CERTIFICATE OF USE AND OCCUPANCY Issued to Robert Manni Address Lot #4 6, 49 Natka Drive Centerville, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ... Aug u s t..2.'., 19......8 8....... ... ......,.. , v ................... Building Inspector �..� °•� TOWN OF BARNSTABLE BUILDING DEPARTMENT 2 NsaaSrAU : } TOWN OFFICE BUILDING rya HYANNIS, MASS. 02601 '�'o lur►. MEMO TO: Town Clerk FROM: Building Department DATE: A,4 Z 1,9fOp An Occupancy Permit has been issued for the building authorized by BuildingPermit #.........--�.... ? .»P...........................................................................................:........................_........»......................„..... issued to�!'�....t7itw/.............4141 ��....... ...... 1/ 3.. ! . ........... � Please release the performance bond. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A m / �C(' �'J IL DATA TOWN OF BARNSTABLE, MASSACHUSETTS BUILDING PER '.• . OAfE 19 PERMIT NO.! � APPLICANT ADDRESS lli I (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO .;4! '., i 1 .. � -,.�i ` DUMBER OF, ..�. +. .. '.. .,_ .(`) STORY •i?'..a.,.' .... i',.iti;,, DWELLING NITS (TYPE OF IMPROVEMENT) NO. IPI7O POSED USE) d .1, " ' :,i 1 ZONING AT (LOCATION) DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE). REMARKS: citidLi AREA OR , :��,,;`:�,(; �'•C; VOLUME .3.1 - ESTIMATED COST y .FPE ERMIT (>r_;.75 (CUBIC/SQUARE FEET) OWNER 1 ,, BUILDING DEPT. � ADDRESS .. BY .?n / ,'f., THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET. ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY c PERMANENTLY, ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE A PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINF FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIO OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. .. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FORELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATH)BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION 9EFORE OCCUPANCY. , POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS -_PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2f 2 l� ----- HEATING INSPECTION APPROVALS ENGINEERIING EPARTMENT 1 k/ OTHER BOARD OF HEALTH WORK SHALL NOT PPi;)CLI-U UN .I. FHf INSPEi,; ?ERMIT 'v:LL..9EC0 .:. V-UL, :,ND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN - TOR HAS APPROVED FHE w mouu3 s:rA,IS OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CONSTRUCTION. PERMIT iS ISSUED AS NO NOTIFICATION. NOTED ABOVE. OTIFICA I FOR BY TELEPHONE OR W'RIT� NTION. r � 1-4 t 4 ;. f t r t- ! ! ttttt i . I + 7 t 1 l , t V ' ,rin. h 77147" 77-IC /alz % �Q�CJ%2 .. - cyc TALE Tc>c,iil�/ �c q�/v��/ � �/7 �✓/t�`c 07 , � { �-aCA-T-Er;> 1A//rq-/.,/ 77LC- Assessor's offioe (1st floor);;' '' SEPTIC SYSTEM MUST Assessor's map,_and lot nu mmber ... . ' Q' I .:. STALLED IN COMP �Q°�`' E r°�o Board'of Health (3rd floor): J '?t-!, WITH TITLES w Sewage Permit number .:...`.:..... :-..��� Z� y ��p� CO,. - •.••'( 1E��VOIO@@15� ENT L �,sed'6. `�;. BAS3.S�"SDLE, i Engineering Department (3rd floor-)': r , ..... t ?a YA� TO R G House number ................ ....`:. . .....�. �...........: D YP APPLICATIONS PROCES SED"8:30 9:30 aye�A.M. and, 1:00-2:00MP•M. only), 4 r . TOWN OF BARNSTABLE BU'ILDIHG 11SJPECT0R APPLICATION FOR PERMIT TO Co:U. .......... .......0�?P.... 5!!�! ....................... TYPEOF CONSTRUCTION .... .......................:.:.............................................................................................. .............................. 9. E TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit-according to the following information: ' Location ........4Q.:!......... ................ ...A47kA........ ..................................................................................................... • Proposed Use ..:.......i:.! Y!^.t.. ,...../1�. .•...............:........................... ............................................................ . �— Fire District d �..05v Zoning District .......................... :. ....... ..:.................... ............. .... ..:........................................... . .. ,Name of Owner . . .�....�.`'�— t c4iiJaV!......................Address .�� � .... � CC:.. ..(...... .!..... !`''�................. ......... . Name of -Builder ' i .�...................................:.Address ..............:.......................................:.............................. Name of Architect .............................I........'.............................Address Number of Rooms ..........> �© C��� ...................Foundation ..... ..,,........... ..........,,...,........................................ L ...............................Roofing 5,1 ..�t<. . ....................................................... Floors .4�J.!^.E/J. .:.............................:.......................Interior ........... �d Heating ........ L! ........................................................Plumbing ...... P/I-oe. `.a................................... ........................ Fireplace ....;...... ....................................................Approximate Cost ............. ®j.000................................. Defin'tive �PI Approved b PI nning Board -� _r�__/_�____-_-_____1A� . Area �'....����. W, s Diagram• of Lot and Building with Dimensions Fee apppe 7S A SUBJECT TO APPROVAL'OF BOARD OF HEALTH _ ilk �. ,. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I .hereby agree to conform to all the Rules and Regulations of the Town of r table regarding the above construction. . S Name .... ............................................................................. ' - d�fv 7 Construction Supervisor's License ..�............................ .' IANNI, ROBERT �Permit for ...I.!. .S.tory.......... Single' Family Dwelling ....... ............................................................. location ..,,,Lot #4 6 , 4.9 Natka Drive Centerville L Owner ........:Robert Manni -=- .. ... ............................... +• Frame ., , �• J . �� � r Type of Construction '................................ :. ............................ ......... ................ 7 ..� .... ....................Plot . . . fs. Permit tGran d 4....M y....-.1:.2..................19 88 Date o°f.- spection ........ ... ..... .. .19 Date C`om'ple d. l '