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HomeMy WebLinkAbout0040 LAKE STREET x i I dcast - 1 i Ganes / y p f CAPE COD T WN INSULATION y �� L.i.S E r'€ h.' f aj f tl' s ,•3 OAfT! 0NiT6! fMltI4110N cmwa! . 1-800-696-6611 Wad 1SMi Job Location Builder Info rx r TI— comtany Name Phone N mber - Date H Y POLYURETHANE FOAMAir w WIN 6 Applicator Name pp' for Signature Installed200. Insulation Statement location of`lnsulation ThicknesS Total R-Value pec ESR 3210L,LApproximate Sq.Ft. Walls i , Attic Cathedral Ceiling In#umescent Coaling fled , location ThicknessJCoverage Rate _t . , (� / `i R-Value=7.4 @ 1" Tensile Strength=45.4 psi Demilee Batch# - 0 Lf Density 2.1 lb/ft3 Compressive Strength=20.6 psi E TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parce Application.# b Health [Division jZ ( _ 14 130eIssued { Conservation Division "- Application Fee Planning Dept. f 3- , *—PeYir�it Fee Q� . F 4 :.3 3(,x .� : e Date Definitive Plan Approved by Planning Board C Historic - OKH _ Preservation/Hyannis Project Street Address L b.l�curl Village �,D-CU 1, Owner 4;;L :2L&A*— W4 LAZLAEl Address ?b`36 `13a Telephone G7 l�•���J`�' O�Qc( Permit Request vT l 7- i rc 3r4& t7L t�Nlt IZr ZE o 9 rl&V vsfr qLH;a L bA/j45`(5_zclV a Square feet: 1 st floor: existing 14L(j proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation _Zla ooQ QP Construction Type W1 F9"t4 , Lot Size ;�Q Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ® Two Family ❑ Multi-Family (# units) Age of Existing Structure 1130 Historic House: ❑Yes 4No On-Old King's Highway: ❑Yes QNo Basement Type: mull ❑ 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: 3 existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: QfGas ®'Oil ❑ Electric ❑ Other Central Air: ❑Yes HNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes €1 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 ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �� � Telephone Number ��DD • (p� (��/` Address 13J_� 4 L License # n �(3 L 0 D4Z35'" Home Improvement Contractor# 0�?7 Worker's Compensation # AWL 70R7 22 _491 V0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �I_ SIGNATUR DATE f c, 'a ^ _ FOR OFFICIAL USE ONLY APPLICATION# >_DATE ISSUED t MAP/PARCEL NO. r ADDRESS VILLAGE 1, OWNER'._... 1 `t r DATE OF INSPECTION: �,D• FOUNDATION " FRAME P3 �$A- off- �� Z 1 12- R MG INSULATION 5I't� 6 Z�7 Z / FIREPLACE L ELECTRICAL: ROUGH FINAL �t r PLUMBING: ROUGH FINAL = `f 'GAS: a ROUGH FINAL 1 �;FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. -- F • t The Commonwealth of Massachusetfr Department of Industrial Accidents Office of Invesggrafivns 600 Washington Street Boston, MA 02111 www maxs gov1dies Workers' Comp ensafion.Insurance Affidavit: Builders/Contractors/Electricians/Plumbers � Apnficant Information Please Priest Legibly ---------------------------------- Name (Business/Orgaaizauonllndmdaal):� �! Address: !!9AIT 7rLl�[=�`r City/State/Zip: L ,u O Phane#: Are YOU an employer? Check in Typ appropriate box: L E-J am a employer with 4. ❑I am a general contractor and I e of project(required): employees (full and/or part-time).* have hired the sub-contractors 6 ❑New construction k 2.T] I am a sole proprietor or partner- listed on the attached sheet; em 7. []Remodeling Mg and have no employees These sub-contractors have $ Q DemoIitian working for me in any capacity. employees and have workers' [No workers'comp.insurance comp..insurance•t 9 ❑Budding addition required.) _ 5. [] We are a corporation and its 10. Electrical repairs or additions 3. J am a homeowner doing all work officers have exercised their []11. Plumbin g repairs or additions . myself [No workers' comp: right of exemption perMGL insurance required:.]t c. 152,§1(4),and we have no 12.❑Roof repairs employees.[No workers' 13.❑ Other comp.insurance requited] *Any applicant that checks box#1 must also M out the section below showing their workers'compcasation policy information t fiozneowners who submit this affidavit indicating they are doing an work and then hire outside contractors must submit a new affidavit indicating such tCantractots that check this box mast attached an additional sheet showing the name of the sub-coat=actnrs and state whether or not thnso entities have employees If the sub-contzactms have employees,tlrey mustptoyide their workers'comp.policy number. f am an employer that is providing workers'compensation insurance for my employees. Below is the poficy and job site information. Insm-ance Company Policy#or Self-ins,Lic. DID—.Expiration Date: y Job Site Address: 4 -- 1 City/state/zip:l i,Tt7 Attach a copy of the workers' compensation policy declaration page(showing thepolicy number and expiration date). Failure to secure coverage as required under Section 25A of MCrL cw 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisomnent, 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' e co erage verification, i I do hereby certify afP 'u►3'that.the information provided above is true and correct Si tore: Date: 1r4f 1-1 Phone#: V Q.ff cial use only. Do not write in this area,'tn be completed by city or town offWaL City or Town: PermitUcense# Issumg Authority(circle one): 1.Board of Health Z:Building Degartmeut 3. Cty/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: DATE(MMIDD/YYY`I) ,acoRo: CERTIFICATE OF LIABILITY INSURANCE 0906?_u"11 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 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 endomement(s). PRODUCER - - CONTACT - NAME: G eun an_hsmance c_ PHONE FAX 908Mahstmel �cr :{508)428'A194 AICN6:(508)4283068 E-MAIL .. ADDRESS: O sterv2h,M A 02655 - - PRODUCER - - - CUSTOMER INSURERS AFFORDING COVERAGE NAIC# INSURED - INSURER A '-FET t VS<i v. _ Pe_rD INSURERS: Po Box!,,; � _ - _ � � _ _ COtiii 1M A 02635. INSURERC:. . INSURER D: INSURER E .. .. INSURER#: . . 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 LTR TYPE OF INSURANCE DL SUBR POLICY NUMBER MMIDDPOLICY EFF MMIDD POLICY EXP LIMITS GENERAL LIABILITY _='i?=tG�'18Ct3 - - t 2. 'O ?::.20:,�. EACH OCCURRENCE $ 1000 COMMERCIAL GENERAL LIABILITY - - - - DAMAGE TO RENTED. - PREMISES Ea occurrence $ CLAIMSAIADED OCCUR - :MED EXP(Any one person)..- $ - PERSONAL 8 ADV INJURY, $ GENERAL AGGREGATE $ 000.u06 GEN'L AGGREGATE LIMIT APPLIES PER - PRODUCTS-COMP/OP AGG $- POLICY PRO-JFCT LOC I I ... - $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $. - • _ (Ea accident) ANY AUTO - - - - - BODILY INJURY(Per person).. $. ALL OWNED AUTOS - - - - BODILY INJURY(Per accident) $ - SCHEDULED AUTOS - - PROPERTY DAMAGE $ - HIRED AUTOS -- - (Per accident) NON-OWNED AUTOS - $ $ UMBRELLA LIAB- H OCCUR F1�CH OCCURRENCE $ ' EXCESS LIAS CLAIMS-MADE - .-. > AGGREGATE DEDUCTIBLE $ RETENTION $ - - . $ .. D WORKERS COMPENSATION -s'C C._...ts-1=01 l�-1G. ' 5.1c,i2.OT1 'S,1o'2:,i2� WCSTATU AND EMPLOYERS'LIABILITY YIN T.- ANY PROPRIETORIPARTNERJEXECUTIVE E.L EACH ACCIDENT OFFICERIMEMBER EXCLUDED? NIA • (Mandatory In NH) E:L.DISEASE-EA EMPLOYE Hyes,describe under - - DESCRIPTIONOF OPERATIONS below E.L-DISEASE-POLICY LIMIT $ 500.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,ff more space is required) - CERTIFICATE HOLDER CANCELLATION. PETER D_FEE.rs SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. i AUTHORIZED REPRESENTATIVE - ©1988-2009 ACORD CORPORATION. All rights reserved ACORD 25(2009109), The ACORD name and-logo are registered marks of ACORD 91te _C Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts.02116 Home Improvement Contractor Registration ^ Registration: 120362 Type: DBA Expiration: 11/30/2013 Tr# 21M22 PETER FIELD BUILDING & RESTORATbN {_ PETER FIELD = d P. O. BOX 16 COTUIT, MA 02635 Ax 4 Update Address and return card.Mark reason for change. -- Address Renewal Employment Q Lost Card DPS-CAT 0 50M-04!04-G101216 Jfze'Vovrarreo�uueau� a��/��4cu,�.cede� -- ---- i Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: G; 9 YP�Registration: �120362 Type: Office of Consumer Affairs and Business Regulation 3 � Expiration 11/30/2013 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 PETER FIELD BUILDING&RESTQ;RATION PETER FIELD `Y 857 MAIN ST. COTUIT,MA 02635 l Undersecretary Not valid with t signatu Massachusetts- Department O'Publie Sayfeti Board of Buildin-Re-ur:rtions and Standards Construction Supervisor License One-and Two-Family Dwellings License: CS 65638 PETER D FIELD i PO BOX 16 COTUIT, MA 02635 3 � Expiration: 7/15/2013 (ianmissiaania' Tr#. 1300 oFE Tom, Town of Barnstable Regulatory'Services , .� . &ARNST"LF4 Thomas F.Geiler,DirBEAMector 1639. Building Division Tom Perry',Building Commissioner 200 Main Street,Hyannis,MA 02601 wwwaown.barnstable.ma.us r Office: 508-862-4038 - Fax: 508-790-6230 Property Owner Must - Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorized t a{ to act on my behalf, in all matters relative to work authorized by'this building permit application for: (Address of Job) of er Date Prnnt ame r If Proerty Owner is applying for permitpleas,e complete the -ra't Homeowners License Exemp tore Form on the reverse side. ` Q:FORMS:O WNERPERMISSION OFTt1E t� Town of Barnstable o Regulatory Services snxxsrnaLu Thomas F.Geiler,Director MASS. 9�p i639• .��A Building Division rFD MA'I , Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# 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 Supervisor. DEFINITION OF HOMEOWNER Person(s)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 he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that.he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-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(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:f6=:homeexempt To whom it may concern: March 14,2012 Pete Field,of Cotuit Massachusetts is our contractor for the house at 40 Lake St in Cotuit Mass effective February 20,2012. Thank You c., Hellie Swartwood . A Malcolm Carley PO box 43 Harvard, MA 01451 978-456-3856 r , SMOKE DETECTORS R9VIEWEa BARNSTABLE BUILDING DEPT. D E FIRE DEPARTMENT DATE .ROTH SIGNATURES ARE REQUIRED FOR PERMITTING RTANT - UPGRADE REQUIRED STAT UILDING CODE REQUIRES THE UPGRADING OF SMODETECTORS FOR THE ENTIRE DWELLING WHEN ONE R VORE SLEEPING AREAS ARE ADDED OR CREATED, NOTE SEPARATE PERMIT IS REQUIRED FOR THE INSTA TION OF SMOKE DETECTORS-THE ELECTRICAL PERM OES NOT SATISFY THIS REQUIREMENT, CARBON MONOXIDE ALARMS MUST BE INSTALLED PER MASSACHUSETTS BUILDING CODE U05ET BATH 51TTING L UP (� MECH. BASEMENT FLOOR FLAN (Pi ? 7)" SCALE: 1/4" I '-O" r000 I I 1 I I I 1 I KITCHEN I DINING fl I I REF. STEP ON IF] I I I I I ❑ II LIVING II UP PORCH F I R S T F L O O R F L ,4 N (FROF05F-D) SCALE: 1/4" 1 t i BEDRO !CLOSET a DN G� BATH CLOSET Z­-- - -------------------------' SECOND FLOOR PLAN (PROPOSED) 50ALE: 1/4" = 1 '-O" LAUNDRY BEDROOM -1 BATH BOILER � WORK BENCH 5TORAGE UP ` STORAbE - BASEMENT FLOOR PLAN SCALE: 1/4" S , i> i PANTRY KITCHEN _ID IN 00 OO F1 DN uviNC7 PORCH F I RST FLOOR PLAN i i i i i ; -------------- i BEDROOM GL05ET rna Li BEDROOM CL05ET I - , ----------------------------- SECOND FLOOR PLAN SCALE: 1/,4" Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATIONr Na G A Telephone Number ddress sy/96A) S l '' License# L-` p 0 T Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE `��/< DAT C ®�,UE�oT o3Gb7 0 2 � ' TOWN OF-BARNSTABLE BUILDING PERMIT APPLICATION-- � , , Map Parcel r U ;Application#�! I (E//' Health Division ,. Date Issued: Ib It Conservation Division Application Fee Tax Collector Permit Fee 5Ob Treasurer Planning Dept. a ,# Date Definitive Plan Approved by Planning Board 1� Historic-OKH Preservation/Hyannis n` ± Project Street Address Village Owner Address L O�30 Telephone Permit-Request"'l , e, 9 i Square feet: l st floor:existing proposed 2nd floor:existing proposed ,`a Total new Zoning District Flood Plain Groundwater Overlay .Z Z, Qfi =g ��Project Valuation z`',S�� Construction Type e o, cam , a.. --�-- Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family .❑ Multi-Family(#units) Age of Existing Structt e 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 CJ new First Floor Room Count Heat Type an7Yes el: ❑Gas Oil ❑ Electric ❑Other Central Air: ❑No Fireplaces: Existing .� New Existing wood/coal stove: ❑Yes o p 9 9 . 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 ❑No If yes, site plan review# Current Use Proposed Use a' BUILDER,INFORMATION p t Tele hone,Number Address S` �� �r License# C'.,FX 3 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE .� t---DATE` " X,2 �. FOR OFFICIAL USE ONLY _ R 1. APPLICATION# = [SATE ISSUED ' MAP/PARCEL NO. ADDRESS VILLAGE OWNER - 1 . DATE OF INSPECTION: y FOUNDATION FRAME I31lK/K ulee`a7/ouck., INSULATION �/ alp l/��-&�o'� ki-t FIREPLACE ELECTRICAL: ROUGH FINAL Y* > PLUMBING: ROUGH FINAL S' ` GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED`OUT 'ASSOCIATION PLAN.NO. , r ",per The Commonwealth of Massachusetts \ Department of Industrial Accidents Office of Investigations • a 600 Washington Street a r Boston,MA-02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electridans/Plumbers Applicant Information .Please Print L elzibl Itz, �e-TH ,lName-(B�r ess/Organization4ndividual): . C City/State/tip: 0? phone.#: op Are you an employer?Check a appropriate bog: :Type of project(required):. 4. ❑ I am a general contractor and I 1.[❑ I am a employer with 6. ❑ ew construction . employees(full and/or part-time),* • have hired the sub- contractors listed on the-attached sheet. 7. [ Remodeling 2.❑ I am a'sole proprietor or partner- These sub-contractors have. ship and have no employees 8: ❑Demolition working for me in anycapacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance$ 5. ❑ We are a corporation and its 10.❑•Electrical repairs or additions required.] officers have exercised their 11.❑Plumbing repairs or additions ' 3. I am a homeowner doing all-work_. myself.[No workers'comp. right of exemption per MGL 12,❑Roof repairs insurance.required.]t c. 152, §1(4),and we have no q ] employees. o workers' 13.❑ Other [N 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 anew affidavit indicating such. , $Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether ornot those entities have employees. Xthe sub-contractors have employees,they must providt: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: 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 c. 152 can lead to the imposition of criminal penalties of a fine tip 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$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the'DIA for insurance covera a verification. I do hereby certi under the pains•and penalties ofperjury that the information provided above is true and correct. .Si afar-ems— �Mttew Phone#: Official use only. Do not write in this area, to be completed by.city or town off cial City or Town: ' Permit/License# Issuing Authority(circle one): -1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5,Plumbing Inspector 6.Other Phone#: Contact Person: Town-of Barnstable Regulatory Services * !ST'"$M x Thomas F.Geller,Director. asess. 9`bpl t63 �`�� Building Division ED MA b , Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax: 508-7.90-6230 Permit no. Date AFFIDAVIT HOME IlY.IPROVEMENT 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. 6 d9l IV Type of Work: / Estimated Cost �4ddress of Work: t/ i�� St Owner's Name Date of Application: 16 .;�- I hereby certify that Registration is not required for the following reas on(s): OWork excluded by law ❑Job Under$1,000 Building not owner-occupied }QOwnez pulling own pemut Notice is hereby given that: OWNERS FULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME I11'IPROVENIENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply far a permit as the agent of the owner: Date Contractor Name Registration No. Date Owner's ame i . i 7ca�aie,vxzxn(enaxtaste.� . . • Aroclfpff"Packs get for tliae aad 4'vro-F'smc`t�'RurdaatW Baildlagv' !mw Wit -Fgals . 144A�MUM 11ffiKIM�1M • Q1a g GrazTr,g Wing wall Moor I!R-Valurl u=m t slab •HeatlaB/Caoling ('��) U-value= R-Yaluet ' R•vatu�e� R•Yalue' Ws11 •I'aimd�tA�ent E[6dea�y' Paekage 3101 to 6500 Hosting llegres D ys! R valuer � IZJa• 0.40 3 10 e 9 Normal 38 1 I • �' . R I2fd M2 30 19 '•19 I0. N0 • I2VA p.50 33 I3 I9 10 3�7(FUE S .13% 036 38 13 25 'NIA NIA: v IS'la 0,46 33 I9 19 10 Elk:: )+Iorrssal �r 15% 0,44 33 13 29' NIA,* U AFM Rr 15Y. 0.31 30 19 19 10 AFUE 13y. 037 3>I •13 23 NIA PI/A Normal y 11%. 0.42 39 19 23 VA NIA Namsai Z 13'f 0.4� 31. 13 I9 Id 4 90 AFUE � lg`!a 00.d0 30 19 19 Ifl '�` AFUE 1. ADtwss OF PROPERTY: , 2, SQUARE FOOTAGE OF ALL.EXMUOR WALLS: 3. SQUARE FOGTAGE OR ALL�tLAZIN4: 4, bLAZINO AREA 413 DIVIDED BY'�2); �. SELECT PACKAGE(Q--AA-sea chart zbave): NOTT;: OTHER MORE DWOLVIt METHODS OF DE iMUMMqG ETERGy REQ�S ARE AVAILABLE, AS•,US FOR THIS MORMIATIONI k9 ot"-t B IDING•L EFECTOR A2noVAL: • YES;, ��� q_g�ris•>3aG303a ' oFZNE, y Town of Barnstable. Regulatory Services nAP.NSS. Thomas F.Geiler,Director �ATfn ;�a1� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,NIA 02601 mrw.town.barnstable,maxs Office: 508-862-403 8 Fax: 508-790-6230 Prop e ' Owne r Mus t Complete and Sign This Section If Using ABuilder I, G619CE as Owner of the subject property hereby authorize oy �� �/ L to act on my behalf, r in all matters relative to.work authorized by this building permit application for: . ®Tug (Address of Job ,so Signature of OwnerJ'te Print Name Q TORMS:OwNERPERMIS SION ' 1 ;t `�► �c F, d I; MWAM t' o0o' � 007 OF'THE ram, Town of Barnstable " Regulatory Services BARNSTABLE, : Thomas F.Geiler,Director 9 MASS. 1639• ,� Building Division rFn �s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE:/0 —��0�) JOB LOCATION: Y'y umber street Q 7X6 . J village "HOMEOWNER": �t+ r name home Ole�-y-- work phone# CURRENT MAILING ADDRESS: /Y)!�/1 J 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 supervisor. DEFINITION OF HOMEOWNER Person(s)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 he/she understands the Town of Barnstable Building Department min um inspection procedures and requirements and that he/she will comply with said procedures and r uir ments. c Signature of Homeowner Approval of Building Official . Note: Three-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(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a superJisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt O OP7 ZZ/�J j C �� a .. •. .. 1 Qt $W W mom 1:f/ e p," Aock Ire I ' f r Town of Barnstable *Permit# 5:) N7 Z h101 p� Expires 6 months from issue date ,M,gr•,B,E, : Regulatory Services Fee MASS v� 1639. ��� Thomas F.Geiler,Director ArEDN1P.tA Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601w -PRESS PERMIT Office: 508-862-403 8 Fax: 508-790-6230 FEB 0 12001 EXPRESS PERMIT APPLICATION Not Valid without Red X-Press Imprint T®WN OF BARNSTABLE Map/parcel Number 6 1 V O / Property Address U?Il sidential OR Q Commercial Value of Work Owner's Name&Address lr nz,,r_ . C CY Contractor's Name- "rr V V W I I (" Telephone Number JCo 6Ll—7—1 s Home Improvement Contractor License#(if applicable)AWW t L3 Q Construction Supervisor's License#(if applicable) Oa lo ( Workman's Compensation Insurance . Check one: I am a sole proprietor ' am the Homeowner AI have Worker's Compensation Insurance Insurance Company Name �} l9 M ��-�t I Unt t o r-1 Workman's Comp.Policy# Permit Request(check box) Re-roof(stripping old shingles) Re-roof(not stripping. Going over existing layers of roof) to-side Replacement Windows. U-Value (maximum.44) Other(specify) r.,* " fY1Q B n 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature expmtrg 1 E i t Cs I (2w, et- -lecycle wilh while paper. - _,.r 5 , r-..'. • -x' f it •. .- - _ - .5.4� t-• ��' 4 't.�i" F.M�{-R H, � AFL t ��e .• "• ,... a - . . . .. _ _'iq. `} <_ � 1+ � �-4 � • � yew ��~ •' V V N. SENDER: I also wish to receive the y Complete items 1 and/or 2 for additional services. m • Complete items 3,and 4a&b. following services (for an extra � • Print your name and address on the reverse of this form so that we can fee): > 4) return this card to you. ra • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address N does not permit. r _ • Write"Return Receipt Requested"on the mailpiece below the article number. 2. ❑ Restricted Delivery G • The Return Receipt will show to whom the article was delivered and the date y c delivered. Consult postmaster for fee. d 0 3. Article Addressed to: 4a. Article Number c _d Eugene & Grace McCarthy P 015 496 614 '3 Cushman Street 4b. Service Type cc ❑ Registered ❑ Insured -Plymouth, MA 02360 c y X Certified CO ❑ D N k� Ezpr O urn Receipt for 5 W y e handise C 7. Da eli w o T Z 5. Signature (Addressee) 8. Ad re s re s ( ly if requested c and ee cc 6. Signature (Agent) aQ ~ 0 PS Form 3811, December 1991 *U.S.GPO:1993-352-714 DOMESTIC RETURN RECEIPT UNITED STATES POSTAL SERVICE Official Business PENALTY FOR PRIVATE USE TO AVOID PAYMENT OF POSTAGE, $300 Print your name, address and ZIP Code here TOWN OF BAR DST ABLE BUILDING DIVIS ION 3 67 MAIN S T HYANNIS MA 02601 P 015- 496 614-- Recaipt f& Certified Mail No Insurance Coverage Provided. Do not use for International Mail ISee Reverse) Sent to Eugene & Grace 'McCarth Street and No. 3 Cushman Street P.O.,State and ZIP Code Plymouth, MA 02360 Postage $ Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing p� to Whom&Date Delivered m Return Receipt Showing to Whom, c Date,and Addressee's Address 7 TOTAL Postage &Fees Postmark or Date M E o. STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(we front). a 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attachbd and present the article at a post office service window or hand it to your rural carrier(no extra charge). QC 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of the article,date,detach and retain the receipt,and mail the article. 0) 3. If you want a return receipt,write the certified mail number and your name and address on a c return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. O O 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M endorse RESTRICTED DELIVERY on the front of the article. E o 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If U. return receipt is requested,check the applicable blocks in item 1 of Form 3811. a 8. Save this receipt and present it if you make inquiry. 1025e5-93-Z-0478 I - The Town of Barnstable • .a>zxernai.>„ • MAW � Department of Health Safety and Environmental Services +" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner April 26, 1995 Eugene and Grace McCarthy 3 Cushman Street Plymouth, MA 02360 Re: 40 Lake Street, Cotuit, MA Map/lot 020.019 Dear Property Owners: This office is in receipt of another complaint alleging that your tenant is still operating a business at the above referenced location and has multiple unregistered vehicles on the site. '. Please contact me as soon as possible regarding this matter. I may be reached at 508-790-6227, weekdays from 8:00 - 9:30 a.m. and 3:00 -4:30 p.m. Very truly yours, a . Gloria M. Urenas Zoning Enforcement Officer GMU/km t cc Thomas Geiler,Director of Health, Safety&Environmental Services CERTIFIED MAIL P 015 496 614 R.R.R. r Q950426A 7 -- // i n i i A \...;q TOWN OF BARNSTAB,;J� 1 BUII.DINGN'DEPA-RTMENT� COMPI.IIINT/INQUIRY AepORT " Date `��� 9 — .. Rec'd By Assessor's No _ �e t Last Name . P a 'w mrrta hr ti Fz ORIGINATOR Street~" Villa a u � w k w 4 -;*.sty€+� -} fi w-iw«'aM .. e rF*`. .p -State:. i...k.',eea,Nq.•�;'�1G §;.. �i`.'S 'n`5� 3�so-4•,e�+k "�Ta 3�.. s . -- S7 R' s C '�i` u"ji"-�F.. .,dt'� Y �,.r- �,t4Y`�i�T`.5�.-.��54.. 1= �4 L�,:Sw�''`t"t�.Y.;- Y'••'r..•.:�' 2'-W,r'{.F Y,3-.;� Tele hone: Home Work Descr a tion- .. S :y 3 51'• T F C��Z�NT r J r S { 'S Y, x c.x � F COMPLAINT " ;Street~ Address ' 0 LOCATION `iell—lse-li OFFICE US£ O!.'LT INSPECTOR'S Date�� x�� ACTION/ Ins ector COUNTS hDDi iOI:I,I, •, 'F h-TFCUED CO?Y DIS:'r�ZEUTIOt:i YRITE - DiPhF?iY:2:T FILE YELLOW PZ1:F. - It:SPECTOR Il:SPECTOR (RETURN TO OFFICE Y.GR.) KZSCl r ' �.. : The Town of Barnstable MAM• axxsrnsiE. • �� Department of Health Safety and Environmental Services ram" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner November 15, 1994 Eugene and Grace McCarthy 3 Cushman Street Plymouth,MA 02360 Re: 40 Lake Street, Cotuit, MA Map/lot 020.019 Dear Property Owners: This office is in receipt of a complaint alleging that your tenant is operating a business at the above referenced location. Please contact me as soon as possible regarding this matter. I may be reached at 508-790-6227, weekdays from 8:00 -9:30 a.m. and 3:00 - 4:30 p.m. Very truly yours, Gloria M. Urenas Zoning Enforcement Officer GMU/km Q941115A L L A 1:'.'E s E E T C T y r E ED` t:-.K7 v hA A T f-,A PCA I I I F�l c S, OCI rf CWI R E A P 2­7 E rl m A A R - 7 r k.E A"' '03 f t r"I Sp i Lj I I li T'21 nil A •4 l P L'If 1PIC-1 U"rl F I MA • y B I 1:D 6 0 B IS T `3 L.A N%f'xy, MF t, ............... T TRUE L i.,LA 3Tr. UT - L.--. It S.T", I ASD C-Ir" -,0- A 4�:-,�**,%,*.')C) A S E; M 7r rvml-' C A R r-k,T r i-,i-%,i "RE 'T -r v .2 J; .3 k_1 1 1 r1l fl. I r�. CURI P4 EAX E 1p'llf 1' 1 &i ea.Pi 2.L.!-,- c D"i f T"ill -r-1%y OWL. 'L..Ar:*.'!.':* ST �:-v F.",f 4 F,- 00 ry R -s—oi i #S F-11. Lf.*:"'ll-Jl.NS r"i i_; r,r-i f-A lyt r-r",r,i,n.! US IT I A' E X E P I PT 101 iNI S-3 SALE A S l f -2 13 1) TOWN OF BARNSTAB7Z BUILDING DEPARTMENT- COMPLAINT/INQUIRY vFtfPORT Date -.�- �T_ Rec'd B Assessor's No. bast Name First Name ORIGINATOR v Village State Zi Telephone: Home 'Work . Description: -COMPLAINT �kv�p INQUIRY U - Requestor's Signature COLAINT Street Address LOCATION A= OFFICE USE ONLY INSPECTOR'S Date- A,5p t inspector ACTION/ / COMMENTS �ln� FOLLOW-UP ACTI011 A DDI i ZOi1AZ. INFO. ATTACHED COPY DISTRIEUTI017: L:F.ITE - DEPhRTYZl;T FILE YELL40 - INSPECTOR PINK - INSPECTOR (RETURN TO OFFICE Y.GR.) KISG1 r FROM , y TOWN OF BARNSTABLE BUILDING DEPARTMENT 367 MAIN STREET HYANNIS, NSA 02601 SUBJECT: FOLD HERE - DATE - _ .. MESSAGE �°��. C '°� � if G G x5 l< SIGN /�/jf Z�Ite"- -'z DATE!®. �%I9 REPLY lce-xi� C/1, - SIGNED 7 NeT-eMi RECIPIENT:RETAIN WHITE COPY,.RETURN PINK COPY SENDER:SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTAC�r' TO i - ice` .F �; ,f,,rf . u; , ; /. "TOWNOF BARNSTABLE `rf 387 MAIN STREET' HYANNff5,MA 02801 Phone:T-Va-4420-- SUBJECT: FOLD HERE - DATE MESSAGE ( J ff SIGNE . • - DATE - REPLY N137-RMf _ RECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY