HomeMy WebLinkAbout0258 OAK STREET (CENT./W.BARN) )T
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Case#: C-19-563 Address: ROADWORK ROADWORK I Date: 7/10/2019 D)
Owner Info: Property Info:
MBL:
Owner Notified?:
Complaint Details:
Type of Complaint Classification of Complaint Method of Complaint
Signs, Zoning, Low Priority Phone
Complaint Summary:
Sign for Kitchen Countertops Direct posted somewhere between 240 -258 Oak Street, mm/Wb area
Acton History:
Action Taken Date Description Fee Inspector
Inspector Assigned to Complaint: carterj Filed by: andersor
Comments:
Comment Date Commenter Comment
7115/2019 carterj talked to a company representative in regards to the sign. He agreed to
remove sign without question. will keep open until removal is confirmed.
7/19/2019 carterj sign removed, closing complaint. no notifications required
Date` 7/19I2019 Town of Barnstable
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IKE Town of Barnstable *Permit# �S S
Expires 6 months from issue date
,,,�� , : Regulatory. Services Fe �
9� MASS' Thomas F.Geiler,Director
A i639. .p10 �
Building Division.
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
EXPRESS PERNIIT APPLICATION - RESIDENTIAL ONLY
r Not Valid without Red X-Press Imprint
�/�
Map/parcel Number ^ 1 /y
Property Address
Residential Value of Work Sao
Owner's Name&Address I
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable) I VS I
Construction Supervisor's License#(if applicable) "
Workman's Compensation Insurance -. '_. __-- X-PRESS PERMIT
-
Check one: -
❑ I am a sole proprietor MAY 2 3 2003 -
❑ I am the Homeowner -
I have Worker's Compensation Insurance TOWN OF BARNSTABLE
Insurance Company Name
Workman's Comp.Policy# (;ICI O)L— Oa-'a_
Permit Request(check box) nn 1 l
Re-roof(stripping old shingles) All construction debris will betaken to P 4►��� � �4 1 �y TC Vh s
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. U-Value (maximum.44)
❑ Other(specify)
*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.
Signature(/\
Q:Forms:expmtrg
Revised121901
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The Commonwealth of Massachusetts
Department of Industrial Accidents
r.d — Office offnsestigations
l 600 Washington Street
Boston,Mass. 02111
Workers' Compensation.Insurance Affidavit
a b'IeaINN
name: / "1G
location:
city l (j `\f Gl V\'), phone# 7 --
❑ I am a homeowner performing all work myself.
❑ I am a sole proprietor and have no one working in any capacity
[� I am an employer providing workers' compensation for my employees working on this job
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❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who
have
the following workers' compensation polices
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Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature Date
Print name_ �r-K �I r k Phone# 1 Z qt)
official use only do not write in this area to be completed by city or town official
city or town: permit/license# F—Building Department
[]Licensing Board
check if immediate response is required ❑Selectmen's Office
Health Department
contact person: phone#; I-10ther
4= _
(revised 9/95 PJA) J =- 1
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all a ployers to provide workers' compensation for their
employees. As quoted from the"law", an employee is defined a every person in the.service of another under any
contract of hi e, express or implied, oral or written. `
An employer is dig fined as an individual, partnership, associate n,corporation or other legal entity, or any two or more of
the foregoing engag d�iin a joint enterprise, and including the egal'representatives of a deceased employer;or the
receiver or tiustee of a %mdividual, partnership, association r other legal entity, employing employees. However the
owner of a dwelling hou `.shaving not more than three apart ents and who resides therein, or the occupant of the
dwelling house of another "ho employs persons to do mai enance, construction or repair work on such dwelling house
or on the grounds or buildin �` ppurtenant thereto shall not ecause of such employment be deemed to be an employer.
MGL chapter 152 section 25 also�tates that every state local licensing agency shall withhold the issuance or
renewal of a license or permit to o�e�rate a business o to construct buildings in the commonwealth for any
applicant who has not produced acc table evidence f compliance with the insurance coverage required.
Additionally,neither the commonwealth�`or any of its olitical subdivisions shall enter into any contract for the
performance of public work until acceptablyevidence compliance with the insurance requirements of this chapter have
been presented to the contracting authority.
Applicants ``
Please fill in the workers' compensation affidavit co ple ly, by checking the box that applies to your situation and
supplying company names, address and phone numb rs alo, with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accident for con T ation of insurance coverage. Also be sure to sign and
date the affidavit. The affidavit should be returne to the cityNr town that the application for the permit or license is
being requested, not the Department of Industrial cidents. Sho,Id you have any questions regarding the"law"or if
you are required to obtain a workers' compensatio policy, please c ,11 the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and r nted legibly. The Departm t has provided a space at the bottom of
the affidavit for you to fill out in the event the ce of Investigations has to co�i act you regarding the applicant. Please
be sure to fill in the permit/license number whi h�will be used as a reference numb r. The affidavits may be returned to
the Department by mail or FAX unless other a angements have been made.
The Office of Investigations would like to tha k/you in advance for you cooperation and ould you have any questions,
please do not hesitate to give us a call. �'
The Department's address,telephone and fax 'umber: \
The ommonwealth Of Massachusetts \\
Dep k4ment of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 ext. 406
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°pIME Tom, Town of Barnstable
Regulatory Services
BMAM MWFrABLE, Thomas F.Geiler,Director
039..�A�0 Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Permit no.
Date DS—`L2 —Q3
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions, along with other
requirements. �
Type of Work: �cr�pn� Estimated Cost Oc)
Address of Work:
Owner's Name: u—
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
[]Building not owner-occupied
❑Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Aar\� ti�41G{cso^
Date Contractor Name Registration No.
OR
Date Owner's Name
Liberty Mutual Group
PO Box 8094
,Yw�"' t Wausau,WI 54402-8094
Mutual. ,Tel�lione(800)653=7893
Fax(715)843-2650
December 11,2002
TOWN OF BARNSTABLE
BLDG DEPT
367 MAIN ST
HYANNIS,MA 02601-
RE: Certificate of Workers Compensation Insurance
Insured: NICKERSON HOME IMPROVEMENT INC
PO BOX 2476
ORLEANS,MA 02653
Policy Number: WCl-31S-318102-022 Effective: 11/6/2002 Expiration: 11/6/2003
Coverage afforded under Workers Compensation Law of the following state(s): MA
Employers Liability:
Bodily Injury By Accident: $ 1,000,000 Each Accident
Bodily Injury by Disease: $ 1,000,000 Each Person
Bodily Injury by Disease: $ 1,000,000 Policy Limits,
As of this date,the above-referenced policyholder is insured by Liberty Mutual Insurance Company under the
policy listed above.
The insurance afforded by the listed policy is subject to all the terms,exclusions and conditions,and is not
altered by any requirement,term or condition of any or other documents with respect to which this certificate
may be issued.
This certificate is issued as a matter of information only and confers no right upon you,the certificate holder.
This certificate is not an insurance policy and does not amend,extend,or alter the coverage afforded by the
policy listed above. -
If this policy is cancelled before the stated expiration date,Liberty Mutual will endeavor to notify you of such
cancellation.
0001,
AUTHORIZED REPRESENTATIVE
LIBERTY MUTUAL INSURANCE GROUP
This Certificate is execinad by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those conies.
cc:..Insured: -. Producer of Record:
NICKERSON HOME RvIPROVE TENT INC PIKE INSURANCE AGENCY INC
PO BOX 2476 PO BOX 1658
ORLEANS,MA 02653 ORLEANS,MA 02653
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NICKERSON HOME IMPROVEMENT, INC. 1112
P.O. Box 2476
HYANNIS, MA 02601
(508) 790-5880 Fax (508) 255-5107.
-,, Val Santacqua - 508-420-244$ ..._3/26/2003�____..
258 Oak 'Street J C G P3A Nil E
W Barnstable MA 02668 258 Oak Stree
Centerville
Estimate does not include rot repair
Only items specified are covered by this proposal .
Materials are warranted by manufacturer
Labor warranted by Nickerson dome Improvement for 5 years
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= ...•. �. >, ..„Y`�". - by'.fUCrllSit i71atL'fir~•i and labor COC'i'1Diete 1r)uCCOrdanC2 Niiifl i!'.-t c^.i30'1B SpBCIfICatiOi'1S, IQi tfiE.'.sun of:
_ _ daliars
71-rnenF io bz made as iollosrs:
deposit upon signing, progress payments upon' request, balance upon
completion
All material is guaranteed to be as speciiied. All work to be completed in.a:professional
manner according to standard practices. Any alteration of deviation from,above spVGfica- Authorized !
lions involving extra cost; will be executed only upon written orders, and will become an Signature
e;:tra charge over and above the estimate. All agreements contingent goon strikes,accidents or
d:,lays beyond our,control. Gvrner to cagy tire,tomado,and other necessary inawnnce.our i4ale This propasal may be -
Wo-kern<^.r•3:u!ly covered by V'Vorker's Compensation Insurance.
vdt;idrav n by us if not accepted within 30
c C Eat��rs�?;.:1�: �dO ' SAL --The hove prices, specifications
end conditions are safisiacicn/ and are hereby accepted. YOU are autizori ed Signature
to do tiie work as specified. Paym.nt till be made as outlined above.
Signature
Date of
20121
TOWN OF BARNSTABLE Permit No. -------------------------------
I BAUSTAU Building Inspector
• Cash -------------0.00
---------
u OCCUPANCY PERMIT Bond ----_____
"No building nor structure shall be erected, and no land, building or structure shall be
used for a new, different, changed, or enlarged use without a Building Permit therefor
first having been obtained from the Building Inspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."
Issued to Suffolk Roalty Address Box 308, Centerville, MA 02632
lot #56 258 Oak Street, Centerville
Wiring Inspector � , � Inspection date
Plumbing Inspector _ Inspection date
Gras Inspector �� R Inspection date
Engineering Department Inspection date
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.
,O� // 57- -'?
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7� /�• SEPTIC SYS-,,"- i MU:;T DE
Assessor's:map and lot number 9-3 ' 'NSTALLED {IV C®iV'PLe,QIVC�
. /L ' Z/ .
"_ '�VITFI ARTICLE If STATE
° 7Afvirq
o/ Y CODE AND TOWN j
Sewage Permit number y p+
F Ql4Z 1 ry-!1f®NaBc
g J —
°FT"Er°�y TOWN OF BARNSTABLE .
a
Z BAHBSTALLE, i
"6 9 ,e0� BUI .DING INSPECTOR:
'FD MPY a'
APPLICATION FOR PERMIT TO ll.......`;11.C.. ...PCe.—&� ...Z ga z ...................................... .......
I TYPE OF CONSTRUCTION .... ................
...!!F �.............. .19..z
_ �TO TH.E_,.I,NSPECTOR_QF BU.ILDINGS:...__
_ The undersigned hereby applies for permit according to the following information:
9 Y PP P 9 9
Location n ... -s�. 44.......�.1. ......................................................
ProposedUse ... '�R/ �Q.. . ....................................................................................
Zoning District ......�. �����
...................................................Fire District ..... ..........s .:.....................................
f�7`-,�.`� ee..�sAL?� .....Address Q �� ..... .. ..o ..... 1...
Name of Owner ... ....... E�� `�v��
11
Name of Builder .............:......................................................Address ..... ........ . ......................... ... .............,.:
Nameof Architect .....................................................:............Address ............................................................
Numberof Rooms ..... f. ./.�....................................:...............Foundation ......... '?'...................................................................
Exterior ..ee ...5 !NA�p.S ......................................Roofing ' .......... .........
Floors .... .. .!!�!� z...... ...........................................
(? � .. ... ....................Interior«.`.. ?.�✓lcS
Heating ..: .... .....Q. ....................................Plumbing�"p, •. .:............................................. ...............
Fireplace ......Ae ..C.e7.....t...,6.4O.C:'.! ..............................Approximate Cost ... /...adCQ..................................
Definitive Plan Approved by Planning Board -----------_-------------------19_______ Area ....../G.J ..... '.....'...
Diagram of Lot and Building with Dimensions Fee o1S
SUBJECT TO APPROVAL OF BOARD OF HEALTH 6,0
i86QQ s
e
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ............ ...........................
Suffolk Realty
2.0.121 .,.�Permit- for .........oae...s.t.o.r.y....
.. .. .. .... ..
single lfamilv dwelling..................... ng
.......................
Location ........2.58 Oak St.
Centerville
...............................................................................
Owner ........... Suffolk Real�y
................................. .................
Type of Construction .............frame
.............................
.......................................................... .....................
Plot ............................ Lot ...........#56 ,
......................
PeIrmit Granted ............Apr.il..20......19 78
Date of Intpection ..................................... 19
,Date Completed :.19
PERMIT REFUSED
................................................................ 19
...............................................................................
........................................................ ........ .............
...................... ......................................................
...............................................................................
Approved ................................................ .19
...............................................................................
...............................................................................