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HomeMy WebLinkAbout0689 MAIN STREET (COTUIT) e3;7 f' 4 r l r I M 1 Application number... .......d9j. Date Issued....................... .11•a. ....... .............. ' A s M ' Building Inspectors Initials....�1 JUL 8 2018 Map/Parcel......b.3.G... ..... ... . ................�... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WIND O W S/DOORS/TENTS/S TOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: b / 100'1A L,d S rk; Z;r CC Tu i 7' NUMBER STREET VILLAGE Owner's Name: PgVl,,4 T S' Pit E L, I. Phone Number 5-O 8 42,0 Email Address: Cell Phone NumberTwl` abb - CA DQ Project cost $ 13, D 0 4a Check one Residential �� Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize I V1, to make application for a building permit in accordance with 780 CMR 1 - Owner Signature: Date: TYPE OF WORK 'E Siding 0 Windows (no header change)# ED Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review 0 Roof(not applying more than I layer of shingles) Construction Debris will be going to Yl4RI*,,l e u7-i// Y�6��'cs� 4, AA i.1i CONTRACTOR'S INFORMATION V�Contractor's name c 7-6 9 �� YY/G IV l I<A//��FW Home Improvement Contractors Registration(if applicable) #_`00® (attach copy) Construction Supervisor's License# (attach cop Email of Contractor Vic p`vA Wtzov, JIVE AJ Phone number,:z$ _U 2 7?10 ALL PROPERTIES THAT HAVE STRUCTURES OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. 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-4:34pm. 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 ' b Homeowner's Name: Telephone Number a 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. r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street, Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): C7—Q1 is VV (f GAL L �/�`/V-EY Address: .3-4? CAfs City/State/Zip R/wsl' 13.E ! o Z!6 3 a Phone#: _� 0 262_ 7 0 L® Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with , . 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.[ Pam a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in an capacity. employees and have workers' g Y P h'• $ 9. ❑Building addition - [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.[ "Other St 01 JV G 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 thepolicy 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 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. Idoherebycertihv under the painsnaides of perjury that the information provided above is true and correct. ^��""� Date: LJ 7 1 9 / O Signature: *� 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#: 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." k An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or 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 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,_supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of 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 bum 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 Accident Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 446 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 wvvw.mass.gov/dia /1B- �l11Y1117f+lZCI'PII.��G�..✓�Uld:J3<ICYGCIJr"�1'�. � . Officatt Conwn►er It Stwrio,"Regu"On HOMEIMPRO" MENT:cONTRAcfOR TY,kE.lndividual w zz I M— : 06lU s a. VICTOR J.W It � r__R VICTOR J W41NliCA ' 12, 56 CAPE COD:LN BARNSTABLE,MA 026W UnderSecreta ry - Cornmonweatth of Massachusetts setts of f'rofessio.riaf Licersure Board of Building Regulations and Standards Constr t r l i rvasor CS-000998 � r pines 09129/20/9 '. _ VICTOR J WHAIKAINEN� �g PO BOX 69 � -m WEST BARNSTMIMM, MA 02668°° Commissioner Town of Barnstable Building P;ostThis Card So ThaUit is U�sible FromftheStreet kApproued PlansMust be Retained on Job and;fh�s Card Must be Kept b Posted Untilfmal Inspection Has Been Mader r f r l R Where%a certificate"=of�Oecu anc ,,is�Re ured -such Buildm shall.Not be Occw ied unt�l£a Final Inspection hasbeen rna"de 1 erlllll. Permit No. B-18-1112 Applicant Name: VICTOR J.WIINIKAINEN Ap provals Date Issued: 04/13/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/13/2018 Foundation: Location: 689 MAIN STREET(COTUIT),COTUIT Map/Lot: 036 013 Zoning District: RF Sheathing: Owner on Record: BUELL, PHYLLIS H TR ';� �� <� Contractor NameVICTOR J WIINIKAINEN Framing: 1 Address: 4 CIRCUIT ST Contractor�License' CS 000998 2 NORWELL, MA 02061 ,• sEs Project Cost: $2,240.00 Chimney: Description: replace windows and one door Pe"rmi Fee: $35.00 Insulation: Raid $35.00 Project Review Req: Final: Date 4/13/2018 } sJ e$ `_ Plumbing/Gas f Rough Plumbing: Building Official 3 � �• _., Final Plumbing: This permit shall be deemed abandoned and invalid unless the work auth�onzed'%this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved appiicat�on and the,approved construction documents#or which this permit has been granted. x, Final Gas:. All construction,alterations and changes of use of any building and structures shall,be in compliance with the local zonh'mgby�laws and codes. This permit shall be displayed in a location clearly visible from access street or roadiajnd shall be maintained open fori ublic inspection for the entire duration of the Electrical work until the completion of the same. 3 �' Service: The Certificate of Occupancy will not be issued until all applicable signatures bythe Building and Fire Officials areprowdedon this permit. Minimum of Five Call Inspections Required for All Construction Work , ' 1.Foundation or Footing ... Rough: 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages 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 Town of Barnstable *Permit#9'18 - 1 f 12 Building Department a 6monthsfrom issue date Brian Florence CBO r ems• •� Building Commissioner 4 i639' eft)MA't A 200 Main Street,Hyannis,MA 02601 t� www.town.bamstable.ma.us �� Office: 508-862-4038 508-790-6230 EXPRESS PERNHT APPLICATION - RESIDENTIAL ONLY © � of Valid without Red X-Press Imprint Map/parcel Number 1 Property Address 4 ` ! f �i(( co Z 2 Residential Value of Work$ �Z Minimum fee of$35.00 for work under$6000.00 Owner's Name&Addressn�'� 4m Contractor's Name ! e I® 2� �! elep T hone Number /-� Home Improvement Contractor License#(if applicable) /0 Email: Construction Supervisor's License#(if applicable) 8 ❑Workman's Compensation Insurance Check one: PRE OR ! [�a sole proprietor ° ❑ lam the Homeowner ❑ I have Worker's Compensation Insurance APR 13 2018 Insurance Company Name ! n A N O� BAHN&LABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) . ❑ Re-side placement Windows/doors/sliders..U-Value_� � (maximum 32)#of windows #of doors: .*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement.Contractors License&Construction Supervisors License is required. SIGNATURE: QAWHILESTORMEXPRESS2017 } The CommompeaUk ofMassadrusettr DeparhmtvFt of Industrial A.cciderrtr - Off"ofinvestigadens 600 Washington,Street --s Boston,MA 02111 NTnrkers' Compensaiiun.Immn-ance Affidavit:Builder-(ContractuursMecc icians(P hers Applicant Infurmatian Please Print E.e�r�ly Name fRncitrPecAChag �/jtltiilE73l, L t_f® -� �%X CL tl �l Address: C*JSta&ZiF"R AfS7- t34 A ta,2 Phone Are you an employer?Checkthe appropriate bon '4. T. project am a general t:oafzactar and I �of F ject(required): 1.El I am a employer-kffi ❑I g 6. ❑New constructicn �Plo s(YhU andfor part-timer* isave bired the sub-contcactors 2.Q� I am a sale propdetor orpartuer- d a4 the attached sheep ?. ❑Remodeling ship and have no.employees . These sub-coutractars have 9_.0 Demolition wcAdn-, for me ezztltloyees and have wogs' � fY 4. ❑Building adxiitior! INO woflrem Camp.insurance comp.ms'ura MI re wire&] 5_ ❑ We are a corporation.and its 10.❑Electrical repairs or addifions 3_❑ I am a homeowner doing all vark officers have exercised thek 1L❑Plumbingrepairs or additions ntpsetf[No wo&='otamp_ xight.of exemption per MGL 17❑Roof repairs iostrGanrerequired,]i C.152,§I(4} and We have no r employees [No WITlEQ3' 13.�therll�// ��sto� comp-insurance ] > ;Amy L"HcsaLdac cbedmboa 91 most alm ffioathe sw imliffewshmxing dAwvm keW campensatieapeEcpiafaemaaaL Homeowners w1w submit this affidavit ubffrztmg they axe don.-RU waik sad th bEm aatside rouftwtommast submit anew affidavit iodicsring mcb- ZbantmctmtTixt6PrJr sboxmmstg=rI, mm sdelitiansa dwzt sboaitxg&an=eof fbg sulb-maimctom sad stdawbetheraraatfhaseerfitieshwe wVbyees.Tftbesdbe=bxctarsbaveanplay-ee%d►ey nnsrpsnuidetheir workececo=p•policy IImibm I ant au employer ffeat is providing warkers'conWensdimz insnraace for my empla yem Below is Ilia patfcy and f ob sfte information. Insurance Company Name: Pflficy ar Self-ius Lit.¢ Expiration Date: Job Site Addre= cifp StateJzip: Aftach a copy of the workers'compensationgolier-declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Sectioa 25A of MGL c.152 can lead to the imposition of criminal pees of a fine up to$1,50a 00 anNor one-year imprisonxnenk its well as tied peuallies.sa the form of a STOP WORK ORDER and a fine of up to$250-00 a day against the violator. Be advised gxat a copy of this stdemem t may-be forwarded to the Office of Itavestigations of 1he DIAL€or insurance coverage Verifi sra Taro&er�by Ul,- sr dM1 as of arfus}t fhatflsa iraforarsa#imtpr6rfdr'd abm�a i g lrsrs and correct Sit tare: Da Phone ik OfjEdid um only. Do slat write in dds area,to be-coinp&8d by city artown afficiat City or Tawn: PermitfLicense# ing Authority(drde one): L Board of$ealt€z 2.Building Department 3.City1rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: -- - - 6 r, Information and T-ustrueffons . . MMassac�setts C=-neral Laws cbaf M regmres all employers to provide warkeas'compensation far their employees. Pm-s¢ant-ID this statute,an E27PLYW is defined as.`�.every person.in the service of another coder any contract cfhire, express or implied,oral or wii tt cn. An err player is defined as"an.indi ' u par[nersh�,association,coipora#ion or other legal en ,or any two or more of the$}regoing engaged in a Joint a terldse,and including the legal representatives of a deceased employer,or the xEceiY.r or trastee of an kdiyidmal,partnership,association or other legal entity,employing employees_ However the o W=of a dwelling house having not more than tbrw apartments and who resides therein,or the occupant ofthe - dwelling house of another who employs persons to do mafiten ce,constaction or repair work on such dwolEng house or on the grounds or building appurtenantthereto shallnotbecanse of such employmentbe deemed to be an employer-" MGL cbaptor 152,§25C(6)also stems that'every state or local Ecenin agency shaII withhold•hie issuance or renewal of a license or permit to operate a business or to construct bzuffdings is the corunaonwealih for any.. applicant who has not produced acceptable evidence of complrance with the insurance.covexage required." Additionally,MGL chapter 152, §25C(7)sW='Nefther the connn6awealth nor any ofits political subdivisions shall ear into any contract for the perfmMance ofpnblic wmk until acceptable evidence of wmpliancewith the requm-emmenfs of this chapt=.hav-e been presented to the confractung 2u D,i :"- Applican-s Please fill oil the workers'compensation affidavit completely;by checking the boxes that apply to your situation and,if necessalL Supply sub-contac nr(s)name(s), addresses)andphme,-r— er(s)alongwiththdr certificates)of ;,= ce. Limited Liability Companies(LLC)or LimitedLiabiility Par�rshfps(LLP)with no eu�Ioyees other.than the members or partners,are not mqui ed to carry workers'compensation i mmlm e_ If an LLC or LLP does have employees,a policy is recjuited. Be advised that this affidayitmaybe suTmifred to the Depa-finent of Indu-sfrial Accidents for confmnalion of msnranog coverages Also be sure to sign and date the affidavit The affidavit should beTr.tnmed to the city or town that the application for the pemlit or license is being requested,not the Department of . Ldrrmr. aT Ascir_ Shovldyou have ray gIIest].ons regarding the law or if you are regnhed to obtam a workers' compensation policy,please call the Department at the numberlfstrdbelow- Self-irmnedcompaniesshouldentertheir self-mcrrr;rnce license number on the appr'opriaizr line. City ar Town Officials r _ Please be sure that the affidavit is complete and pmiuted legibly. The Department has provided a space at the bottom of the affidavit for you to EL out in the event the Office of Investigat o„s has to contactyou regarding the applicant Please be sure to fill in the peonitMcrose number which will be used as a mfmrence number. In.addition,an applicant th must submit multiple peumitllfcense applications many given year,need only submit one affidavit indicating cmi at . policy filfb ation.(if necessary)and under`nob Site Ad ss"the applicant should wLite"aII locatii ns a ( y or town)"A copy of the-affidavft that has been officially stamped or marked by they ar inv�may be provided to the applicant as proof that a valid affidavit is on file for fdare'pexm-�:s or licenses_ Anew affidavftmust be filled ovt each e rnit not relain;d fan business or commercial v�� year.�iThe�a.home owner or citizen is obfiauimg a license or p my (L e_ a dog license or permit to bum leaves etc_)said person is NOT regn:¢ed to complete this affidavit The Office of Investigations would IZke to thank you in advance for your cooperation and should you have any queStions, please do nothcsitate to give us a call. The Department's address,telephone and faznnmber. - . e cb l*of Mamach-McE S ' Deparimmt c&T usfziO Accidenta ' Qmca of 1we&frgatio---= 4ingn 2`c,-L,.' 617-727-4900=t4€6 car I-M-MASSAFE Fax#617 27 7749 Revised 4-24-07 -gg��a I °-IMEr Town of.Barnstable Building Department '* &43NSTAB . ' Brian Florence,CBO MASS. i659. a.�� Building Commissioner TED MA'1 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax7 508-790-6230 Property Owner Must - _,Complete and Sign This:.Section If Usi= A Builder o e-LL,as Owner of the subject property hereby authorize V / to act on mp behalf, in all matters relative to work authorized by this building permit application for: �Acx I (i (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are perfortned..and accepted. t S' nature of Owner Signature of%pplicant l liPV t P Name Print Name 6L� l a Da Q:FORMSDVINM PERMISSIONPOOLS Rev: 10/17 'Town of Barnstable t a �DFI Eros, Building Department ~� Brian Florence CBO Building Commissioner v M"ES. 200 Main Street, Hyannis,MA 02601 t6;q. 'OrE Mp'la www.town.barnstable.ma.us Office: 508-862-403 8 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 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 be/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 to amend and adopt such a form/certification for use in your community. ��e �P��wOuaea�a�Ci�/�aa�ae y 4Z\ Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration 100053 Type: 618k2Q18 Individual Expiration.=-= _ VICTOR J.WIINIKAINEM #r I Victor Wiinikainen 58 CAPE COD LN BARNSTABLE,MA 02636 Undersecretary 1 Commonwealth of Massachusetts y t Division of Prof'ssional Licensure F Board of Building Regulations and Standards ConstrUEtibr�$0P rvisor jJ. CS-000998pires 09/29/2019 VICTOR J Wit NIKAINEN PO BOX 69 WEST BAR NSTABLE MA 02668� f i J Commissioner TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel w'Application aol"rTO YIN OF BARNSTABLE" f� Health Division Date Issued .3h1 b-5- _9J Conservation Division C. j (i ' ` Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board { ra Historic - OKH — Preservation / Hyannis Project Street Address I%(sj Village f CS,IULT.Owner Q y elL I Address H Ct(L G 2, /V d"V elt, AlA. TelephoneV Permit Request SD) WIM a-UJM R-c i3 Uo 1�C/t (.� N e44/ I e� 'ru Iefi rfA lN(2 is Sane cockyeos 2,eL0L ie �NSpng GJ S !tm VIA tYL g D QU IS I �C 14S V/11V IT L1 t e[.o CO—e iVJN 0 eo f Square feet: 1 st floor- existing IrlZ proposed (7Z- 2nd floor: existing proposed Total new (0 �``�� Zoning District �F' Flood Plain Groundwater Overlay Al A Project Valuation 3 J� ()0 Q Construction Type Lot Size_�)� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family rg Two Family ❑ Multi-Family(# units) Age of Existing Structure 3U LJ Historic House: 'Yes ❑ No On Old King's Highway: ❑Yes 4No Basement Type: I Full Yi Crawl ❑Walkout ❑ Other Basement Finished Areas .ft. 0 Basement Unfinished Areas .ft LfU U S Number of Baths: Full: existing_ new Half: existing new 0 Number of Bedrooms: 6 existing _a new Total Room Count (not including baths): existing new d First Floor Room Count G Heat Type and Fuel: ❑ Gas U,Oil ❑ Electric ❑ Other Central Air: ❑Yes SIN' o Fireplaces: Existing 1 New C Existing wood/coal stove: ❑Yes L'No Detached garage:;existing exi ' g ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ new size Shed: ❑ existin ❑ new siz h r• g g _ g size e . Zoning Board of Appeals Aut rization ❑ Appeal # Recorded ❑ Commercial ❑Yes o If yes, site plan review# Current Use �S i l?J Pam/(1�, Proposed Use Gv`it APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 'N L l..I I Telephone Number Address ��� (41(llr , License# Oct r) �q 3 ((t-U c YOU, O2,6 Home Improvement Contractor# Worker's Compensation # WC-L Soo ro vl tq Q ((-( A ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO G SIGNATURE DATE Z i • FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER } DATE OF INSPECTION: FOUNDATION FRAME �I �12I Ol s , INSULATION FIREPLACE s . ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE,CLOSED'OUT ASSOCIATION PLAN NO. r i ti 77te. Crinuuontpealtla of.Massachusetts == 1leparMent ofindustrial Accidents Office of Investigafions `= 600 WashiAgton-Street ,�:.. Boston,VA 02111 *0M.111amgotildia 't�sflrkers'.Cnmpensationbmwance Affitlaizt: Builders/Cnntracturs/Electlicians,`Plumbers Applicant-information Please Print Le ibh Name tBasrnes 0 i 3ionrinslivid tal): C4k/(l-q, ( GAQ e (rJn�d� Address: ve-b , City/State/Zip. QTVIT 2 6.3 Phone#: At et 3 ga anemploy er.?Checkthe appropriate boa: 1. I am a employer urith�r . ❑.I a general contractor and I Type of project{required j: employees(full andtor part-time).' hacv hired the sub-contractors 6- ❑R coastattction 2.Q i-am at sole proprietor or partner- listed on the attached sheet. 7- Q2'kdeling shtp:and haw no employees These sub-contractors1a`v & Q Demolition awking for me in:any capacity. employees and have workus' [NO a orb'camp-insurance cam.insurauce.l � ❑Building addition retpire&] 5. Q We are a corporation and its 1013 Electrical repairs or additions 3.❑ I am a homedamer,doing all worit officers have'eRercised their 11.❑Plumbing repairs or additions my-self.N6 we kerrs'cows. right of exemption per 1v GL g 7 Q Roof repairs insurance required.]` C. 152,§1(4);and use have no employees.[No worker' 13.0 Other conga.insurance.requirm.] "Any'9"U=e &m d 2a&stcm 41�1 Lt`81£9 SIId1F t�5[{8L4ff�ietBbLY aI30 Bh�ir anrmr�ers'c- ompensa$anpolScy.infortratson- 'Hamemaen wba submit d9s affid t ia,#tating#� ,are< ad3 alt o a ksre au iaie t ctaz mom t st bstis<a neas a8Fed3c€t ieuaisa s contractors that chedet dies 3rnx mast ucb- attached=addmong sheet shovnng ta:e naz:ee of the sub-co=Wrs and state whether or ttat those enumes b6ty employees. U the sub-caumaors have*rcptogees,dies mmtst p=vve theme.watters't otup.policy number. I asr an empi. r that is ptovi"g- orherr'Mnwaffiuwon insura a for ett�er�rpl ryWM Bdow as flue policy sttd job site informatdom Insurance Company AName: 6M U C . Policy#or Self-ins.Lic.4:_ Lu Ct✓ Expiration Date: Job Site Address: 6 7U I T CitpStatelZip: y►'1 Y} . Q 2-.63 T Attach a copy of the u ork-ers'compensattion policy declaration page(showing the policy number and expiration date). Failure.to seellre-coveragge as required under Sermon 25A ofMGL c. 152 can lead to the imposition of criminal penalties of a fine up to 81,50 .00 and'"one-Yeatr imprisonment,as well as c1,111 penalties in the form of a STOP WORK ORDER and a fine of uplo'$250.00 a day against the violator.. Be advised drat a copy of this statement may be forwarded to the Office of iurestirphons of the DIA for imarranee coverage verification. I do bet eertr,ft!uncle PMns find penames ofpedu t that the informatdon prot*dded above h true and rorrmt Date: Phone O rild use onk Do riot wrke in dds area,to be eompletod by city or town ts, ciaP City or Town: PertnitllAcense# Issuing Authority(circle one): L%ard of health a Building Department 3.Citylr n Clerk A Electrical Inspector S.Plumbing rector 6.Other Contact Person: Phone#: _ 6 Client#:38438 2CENTRALCA DATE%Uuwft-f M ACORD. CERTIFICATE OF LIABILITY INSURANCE 12101/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TH9 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 poilcy(les)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 endorsement(s). PRODUCER Dowling&O'Neil E 508 775-1620 No: 5087781218 Insurance Agency E MAIL ADD ss: 9731yannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A:National Grange Mutual insuranc INSURED INSURER B,Associated Employers Insurance Central Cape Construction Company,Inc. INSURERc-820 Main Street INSURER D COtuit,MA 02635 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 CONTRACTOR 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. ILTRN= TYPE OF INSURANCE POLICY NUMBER EFF POLICY EXP Lam SA A GENERAL LIABILITY MP19764Q 1/14/2014 11/1412015 EACH OCCURRENCE $1 0O0 000 X COMMERCIAL GENERAL LIABILITY7 �S Ea rr� $500 000 CLAWS-MADE ®OCCUR MED EXP Any one person) $10 000 PERSONAL$ADV NAM $1 000 000 GENERAL AGGREGATE $2,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000 000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per acddent) $ AUTOS AUTOS HIRED AUTOS NON-OWNED AUTOS (Pero tDMAAGE $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE _ S EXCESS UAS CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WO�oY NSATIO Y WCCSOOSD 91992014A 1412014 05114/201 X WC STATu OTH- ASU ANY PROPRIEfOR1PARTNERIEXECUTME Y I N E.L.EACH ACCIDENT $500 000 OFFICERIMEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 OQO H yea describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB $500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES wlteeh ACORD 101.Additional Remarks Sdredute,N more space Ls required) Insurance coverage is limited to the terns,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION .1 nd a SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL I D BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2 A,.U,THOPJZED REPRESENTATIVE ry' ®1988-MO ACORD CORPORATION.AN rights reserved ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD I'�S142149/M142148 LS1 dX/ke 'Cam4noitwertlIZA albllkaaiac"e�t Office of Consumer fairs and Business Regulation �K 10 Park Plaza -Suite 5170 Boston,Massachusetts0, 29116 Home Improvement Contractor Registration ffi -Registration. 131841 � {7` iy)32 Private Corporation f �'"GE. -�"��- x& Expiration- 9126-12016 Tr# 256305 CENTRAL GAPE CONSTRUCTION�COL � STEPHEN OEVLIN 1 - ' 820 MAIN ST_ = -- COTUIT. MA 02636 M 4 Update Address and return carr&Mark reason for chaff, s C. i address l Renewal I Employment i� Lost Card "CA .s�. �3illP eLC-JJt7�rC7?.r!%d'iClllL C�/'=r'rdc7�::lrCY'ti{.i�/l C Office of Consumer.affairs&Busies Regulation License or registration valid for individul use only 5101911E IMPROVEMENT CONTRACTOR before the expiration date. .tf;found return to: g Offiee of Consumerwits.and Business Regakton e istratian i3i841 Type- z �$7''Expiration W13 M6 Private Corporation Itf Park Plaza Suite.5370 =` Boston,MA 02116 CENTRAL CAPE CONMUCT-IOINCO.INC. STEPHEN DEVLIN 820 MAIN ST COTUIT,MA 02635 Undersecretary !to valid without signature iWassachusetts-Department of Public Safety i Board of Building Regulations and Standards License:CS497_M p� p�� i 82.0 A1,k v ST Cohat-MA.02636; i r 5;"/.- .tl�ds . 'tl'"' Expiration COnRnissione?r '®ZM4120 6 w Town of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us 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 authorize >��P iTvi tVL46 to act on my behalf, in all matters relative to work authorized by this building permit application for (Address of Job) l Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. 1 TAXM Muilding Changes\EXPRESS PERMMEXPRESS.doc Revised 061313 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 7 Map 0 3(o Parcel - 0 _3_ Application #;�20 /.71) Health Division Date Issued 1 7� Z-- Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address /� A4A/tj Si- Village -7 Owner- P14YAZl �j L L ress 9 %�i9i� �'T �`��✓lT Tele one � 4 ph - <StJc� a 6 /tS 15 f,err _ ♦Permit Request D �D '- 1 ER-10 r S OF bjou5E lO B(Z`.[ NZ E0iZ C7/1- fi 7 AC1,4Gb Square feet: 1 st floor: existing proposed '' // 2nd floor: existing proposed Total new Zoning District Flood Plain A/0 Groundwater Overlay Project Valuation 0�9 dO 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 150 1,42- Historic House: ❑Yes XNo On Old King's Highway: ❑Yes )<No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other LAR-Tl6� Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 3 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: kas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes XNo Fireplaces: Existing New Existing wood/coal st&b: C Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ BarnE0 existing❑ ne- size_ Attached garage:Xexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: `N r•s> Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes )(No If yes, site plan review # Current Use ta i vA- L W�=1 �� �7 Proposed Use SUM (= APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number J'�d�' 4 c .O °D 6162 7.0 Address . C'90 ,t X flip License # ('�,�®� TV 1 t 14 Home Improvement Contractor# (0.5 Worker's Compensation # I-"'--- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 5/99ktJ,577/9 i3e_ jzileJ5F CA- 5�i 77706/ SIGNATURE DATE 73and/ FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE i OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ,.G T PLUMBING: ROUGH FINAL n GAS: ROUGH FINAL FINAL BUILDING ➢, 1ZJ14 r3 IPA DATE CLOSED OUT t _ ASSOCIATION PLAN NO,"-", c The Commonwealth of Massachusetts, Department of Industrial Accidents Office of Investigations 600'Washington Street "Boston,MA 02111 www.mass.gov/did Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers -Applicant Information Please Print Legibly Name(Business/Organization/Itidividual)`. Address: Ca® Ci /State/Zi tY p: (f o-'u I r Phone#: c� Are you an employer?Check the appropriate box: I am a employer with 4. general contractor and I Type of project(required); 1.❑ ❑ I am a employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2V I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. (J Demolition' working.for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.$ 9• ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4),and we have no 12.0 Roof repairs employees. [No workers'- 13.0 Other -comp.insurance required:] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees;they must provide their workers'comp:policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information - Insurance Company Name: . 1 Policy#or Self-ins.Lid.#: 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 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 underthepaj*q andp9gaities of rjury that the information provided above is true and correct. Signature: Date: ,1. Phone#: O8 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 Contgct Person• ' Phone I Town of Barnstable Regulatory Services • snRtvsrnaLE. y MASS. Thomas F.Geiler,Director Fc 9.�oil Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, Alivil-1.5, If'ekZ_ , as Owner of the subject property hereby authorize 6E0X 4: �•�lJD�C/�D to act on my behalf, in all matters relative to.work authorized by this building permit. A; ST. (Address of Job **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Sign e of Owner Signature Applicant Pdit Name Print Name 1� Date QFORM&OWNERPERMISSIONPOOLS 6/2012 Town of Barnstable Regulatory Services . . " lARNSTABLE, Thomas F.Geiler,Director 9 MASS. 4,,, �bs9• A,0 Building Division tFD 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# a 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) x 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 persons)for hire to do such, , work,that such Homeowner shall act as supervisor." . ' . • I 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:forms:homeexempt . i. . r: License or registration valid for individul use only N011(fE 11NE'RQVEMENT CON7 4CT®!2 before the expiratton�date. If found return to: strat�oe 'T e '. Office of:Consuiner.-Affairs and Business Regulation. 91 116605 YP 10 Pa Plaza-Su ' Expo on; 6129120 i2 8� rk Suite 5170 Boston;MA 02116 H.-WOOBWOKS €Qf2C�€ SUOKC6CO a?ocFQ ... R§NECx Oi11 MA� 35'` 4 Undersec ..Y i Yg re.WY lYo .va id w o t si nature - j: n _.. a .Massachusetts —Department of Public Safety Board of Building Regulations and Standards Construction SuperN isor License: CS-066058 GEORGE D siIOKKO 220.CROCK9kS NECK R COWIT MAS 02635r P / r. Commissioner 14t L Expiration' 10/27/2013 ` carbonhns f<: INVOIC D, /00 �QRQk,S tNVO10E DATE , aRDER:�O SOLD TO sM TO SAt.ESPEI�SOiV SMPPED V!A TERtu1S FO B 41 qo N� I /�VC�C .5 �WCIZcL�I t cv j ' a iNjar c7.1 Aw . . . - ' t _ t BY AWN 872 INVOICE } , t b f ! '�vwar+4 wH Y!lWYm•.pw,.y�r �� .. � �/'� �{� � ...�....., _,.... �'1�- •� .� ...ems ., G? " o- f S F � 4r = 'mot gg ..- . � r a f W _ 4EAA., Town of Barnstable Geographic Information System July 3,2012 036031 n "� I #674 036015 #671 036032 #688 Z to • 036013 #689 036012 #699 036049 t #700 036010 #701 0 =Fee , . 036 09 «,6�0s #1 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:036 Parcel:013 - Selected Parcel o boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:BUELL,PHYLLIS H TR Total Assessed Value:$491200 1.,100'may not meet established map accuracy standards. The parcel lines on this map _ are only graphic representations of Assessor's tax parcels.They are not true property Co-Owner:PHYLLIS H BUELL TRUST Acreage:0.41 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:689 MAIN STREET(COTUIT) ' such as building locations. Buffer /„. Assessor's map and lot number ................. / HE T0�4r Sewage Permit' number .. �1�:.. r..S� . •-�'� � SEPTIC SYSTEM MUST ,— House number ..t�t4........ �..................... INSTALLED IN COMP10ANI ,B��a LE, s WITH TITLE 5 . dav•�0� T 0 W N 0 F B A M?TTNUE APPLICATION FOR PERMIT TO .. l� ..........ao/tooh;?....?�... ......:.................................. TYPE OF CONSTRUCTION ........... f...........:............................................................................................... ........................ ....z. ........19..$x- TO THE -INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....f.. .-7.....fqi3!l.el...... ............ 'Q ��. i... !!1. .F .,:�..................................................................................... ProposedUse .... ........................................................................................................................................... Zoning District ...A�..........................................................Fire District ......GP. tr!7`.�..................................................... Name of Owner Alt.$t ry...J�0.1�e....C..zp, �.�N... ...........Address ... ... i�'fl?� 4,!�. lr f�l-...... Name of Builder' .e .................................Address 7 ;'`' Nameof Architect _.- ................................Address .........:.......................................................................... Number of Rooms ....!......I...�3�t-���t'............................Foundation ...C"<�rr,�`.�1�/�/ecf�.......................... I Exterior ../7-n/./1.....................................................................Roofing ......;:P ......! yx?t�ac? .............................. I' Floors _ ...Interior ..../?v.,,1'4.f...�! ...... /j.........................................:.................. �' lr........................................................... Heating ........ .............................................................Plumbing .......%7.<�f7..C'.......................................................... Fireplace .....f!&AO ............................................................Approximate Cost .....�7..%'. ....................................... Definitive Plan Approved by Planning Board --------------------------------19-------- . Area p Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH F_F-17 � o OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .�(2°t!� f ..�•'�`L. .............................. Robinson, Mr. & Mrs. E. H. No ....... fPermit for ...,,add room. & garage to dwelling ....... ................................. ........................... 689 Main Street Location... - Cotuit Owner .......Mr• & Mrs. E. H. "Robinson i .......................................................... Type of Construction frame : d ................................................................................ Plot ... ........................ Lot. ................................ February 23 82 Permit Granted ........................................19 Date of,Inspection,// .......................... Date Completed ....................1.... .19 . X Assessor's map and lot number .:.: 1........ ._. ............ oFTeerc Sewage Permit number .. ....... ?:+.a.. :A:: :-;......!�c •, . �,:f d�' K �� J � � Z 13AE39TADLE. i , House number `,? po,1639 \e00 VIR a• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... r.'>? !'...... f: /r r<r .. .s.:.................. ".................................. ..... TYPEOF CONSTRUCTION ........... f:. r r ....................................:.................................................................... ................................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... y'." �:f< � < `............ ................................................................ Z.................................... .................................... Proposed Use ...,! : .Kr ,� ��•.� .................................................................................................. ...............:................................................ Zoning District .._ ... .......................................................Fire District ......r;."•�'>,7t Name of Owner /4.*;/tl F .....'..n ." -:°:...............Address .....ij:�. ': 'r't r5 ....... ...... ......... . ..................... .. Name of Builder' .ems'.-.........................'�'''' f Address .......:... ......... ..:. Name of Architect ..................................Address ... �' -.r..: '.............................Foundation ... Number of Rooms ........................................... Exterior ... .nZ�X.....................................................................Roofing :' / L ;�r,� �.1" ;... ....................................................................... Floors ......................................Interior .... �g.... .............................................................. Heating ...Plumbing ........1 ..^:''�'............................................................................... ........................................................... Fireplace - Approximate Cost _-'................................... ................................. ........... Q Definitive Plan Approved by Planning Board ________________________________19________. Area .........5?..`!.........;ffl..:.......... Diagram of Lot and Building with Dimensions Fee ` ....... r........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH ,__ f 1114 t. m �`rj ! f# / ;.0 P 4 +Mn,y. ...er -.rhr+w:.-•r+-n.w.e�....nhr+. .m+..�prr�.r�.�n..-..h • +axi•wru ra. • ff OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name : ......... �/%/;, �• t,r^y :............. r ; Robinson, Mr. & s. E. H. A=36-13 No .....23826 Permit for ......add room & ...........garage to;dwellin$............................ Location ........689 Main Street .................................................. Cotuit Owner .........Mr. & Mrs. E. H. Robinson ..................................................... Type of Construction ....,....frame . .............................. ? ................................................................................ Plot ............................ Lot ................................ i a Permit Granted ...,, February 23 ..19 82 Date of Inspection ....................................19 Date Completed ......................................19 •t of r Town of Barnstable *Permit Fxpires 6 months from issue date N IAMSrASM F Regulatory Services Fee d t D 9� `"AM Thomas F.Geller,Director t63q. �0 Building Division XPR Elbert C Ulshoeffer,Jr. Building Commissioner �� �,o 367 Main Street, Hyannis,MA 02601w RA � Office: 508-862-4038 ,''OVVA!O 1200, Fax: 508-790-6230 F EXPRESS PERMIT APPLICION BARNST'�QC Not Valid without Red X-PressImprint \ E Map/parcel Number Property Address ❑'Residential OR ❑Commercial Value of Work Owner's Name&Address R Contractor's Name��m�2 �'7l��r /��1� Telephone Number Home Improvement Contractor License#(if applicable) A o'er — Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Cw Check one: gj-I am a sole propriet6r ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑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. Signature expmtrg _M TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 03( 0 P '3 Parcel '� P '" %: Permit# Health Division Date Issued Conservation Division APMFee -2t Tax Collector Treasurer q i 06 , s Planning Dept. Date Definitive Plan Approved by Planning Board : Historic-OKH Preservation/Hyannis Project Street Address Village Owner C 4�/�E=® � �4F24cldress 4 Telephone 7 ! " S�^ O 3 - Q X-O (9 l Permit Request C f ?re 0 n S Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay 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 ZO C3 I;FW4 Historic House: ❑Yes On Old King's Highway: ❑Yes tE}-Pd"o Basement Type: Cl Full 6;5raV ❑Walkout ❑Other Basement Finished Area(sq.ft.) Q Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing T new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: 615as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 4-Na" Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing O new size Attached garage:4WRisting ❑new size Shed: ❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes AKO If yes,site plan review# Current Use Use BUILDER INFORMATION ,e� Namefly ��r Telephone Number 3 `^ �V Address C cn 'Alt License# Q b Q / Home Improvement Contractor# //,�l O !� Worker's Compensation# -- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TOi�7� SIGNATURE — DATE ` / cs CS q FOR OFFICIAL USE ONLY z PERMIT NO. y i + _ :-'� �'i ••- ,- <�� , G r"7 - 3 „ 3 •.r ` ram. DATE ISSUED t !. MAP/PARCEL NO. 3.- �i 1. l `may •f .s'� P J 3' ( . - f�.f-F 1! � f 5 '.� r R f [ , r 'y R�,+ - • ,.,••>,i �2t j '• .,.,, .'JIB, ADDRESS. .-VILLAGE OWNER• ` ~•' ,(,fir � � �' +i.( � F,/ ! ' 0,4 DATE OF INSPECTION: INA FOUNDATION f•. ^ '. FRAME INSULATION FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 1 {rf tL : DATE CLOSED OUT kct t r ASSOCIATION PLAN NO. t Rai at Department Of n uOdS� ifaWCStfg,i 600 Washington Street Boston,Mass 02111 " �`?' Workers' Com ensation ,Insurance davit OF ON= ��q+LlFZf1IIi'�i3S. Z (a to P (y vocation' O CS` phone# cin C., 17, I am a homeowner performing all work mps 1a an9 caflacity 0,p/��/%00////�/�,��•�' am a sole nraorietor and bave, one woridne wMMOM orking on this job. ::.:::::,,.:.::.:..:.,::..,:,:,....... won for my=PlGr=:,,-•: wozicers .... 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MEN= tO51.e.00.00 or airmail penalties of a Sae IIp required ceder Seetioa 2SA o[MGL 152 can Lead to the im a am o(5100.00 a a[�st me- I vMACr z a Faiiare w Mecum coverage as inthe form of a STOP WORK ORDER and one Years I irnpr isonment s3 van as tiva p—m— o[the DLL for twveeage vain• cony of this stateln�uny be for.Uded to the OIDee of Inv ftdgWdMthe mrd pcnaltits oI Fed s"dud the iaJonriaion QTO1zded above is trw mid cvrrcd I do herekV C - C V— N-T C� Date tr LI - �:'.:,L;.31IIe f do not write in this am to be completed by city or town official otucw use only [3Buadin;DepsrI perruivuCeme ll �jscea>mg Bow city or ton: �Seleeal1eII�a OfIIce w check if immerilata rapome is required _ ❑Health Dep�ent ❑Others--- • phone#: contiLct nel7On' =•a h r - °� The Town of Barnstable r ► � Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commission Permit no. Date AFFIDAVIT HOME IMPROV YIENT 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. INC-- Type of Work:ZEstimated Cost c � Address of Work: Owner's Name: YA Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law CJob Under S 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. � Date Contractor Name Registration No. . { OR Date Owner's Name q:forms:Affidav -zlvft�/ie ,io�ueaY� o�✓ aaoarl uaelta BOARD OF BUILDING REGULATIONS Uceruce::CONSTRUCTION SUPERVISOR n. Number=ES _ 000998 Enpires::09/29l2001 Tr.no: 4330 =_Restricted.To: 00 VICTOR J WIINIKAINEN._^ PO BOX 69 W BARNSTABLE, NIA 02668 Administrator 6}� ^i HONE INPROVENENT CONTRACTOR Registration: 100053 Expiration: 06/08/2001 ' Tree: "Individual f. VICTOR J. NIINIKAINEN Victor Viinikainen WCAPE COD LN ' ADMINISTRATOR � . _ BARNSTABLE MA 01630 i t r En Bering Dept.(3rd•floor) Map Parcel Permit# �� ? _ House# ` ]o , Date Issued ZQ :27-22 r r Fee A and 19 � BARNSTARLE, ' MA039. 5 rFO MPS `� w_, TOWN OF BARNSTABLE- ' Building Permit Application Project Street Address '7 � � Village"' Owner 1 � 9-Wd4 T9- ( `P' Address] d FE C Telephone 7 , Permit Request p o Cp 4l-A--c .�-/g w®.z 4g2 6l/�- BIZ` First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ �� Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Off' ,5 '� Historic House ❑Yes Leo On Old King's Highway ❑Yes ZFo--- Basement Type: ❑Full rawl ❑Walkout ❑Other Coffr an o 9Q L'ai® Basement Finished Area(sq.ft.) 1kr0 0$ 1— Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 3 New Half: Existing New No.of Bedrooms: Existing 4/. New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: s ❑Oil ❑Electric ❑Other ' Central Air 6,Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ttached(size) c4R ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name J, jx el roc► �1 � /' Telephone Number Address (0 41yilpc License# cv4L T s 2, L),( C C e '(W. 0> -Z, Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO "e-ro Ut SIGNATURE DATE 9 U D G P FOLLOWING REASON(S) ,o r - FOR OFFICIAL USE ONLYlk C. M 2 PERMIT NO ' DATE ISSUED - MAP/PACRCEL NO. , may. �< •+« C r` r, � i--�' + - i�ftr{jf ' f`� r•' . - � ry } tf ` .� - `; 1♦ F } " • ADDRESS x _ '. VILLAGE OWNER DATE OONSPECTION: FOUNDATION FRAME r ' INSULATION FIREPLACE r ' =r• ` _ r r ELECTRICAL: ROUGH + ' FINAL l PLUMBING: ROUGH '' FINAL_ r GAS: i ROUGH FINAL FINAL'BUILDING SCII- DATE CLOSED OUT. ' f - ASSOCIATION PLAN NO. i ' r . The :Town of Barnstable 9 "M��' Y Department of Health Safety and Environmental Services ;. + BuiIding Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 BuiIding Commissio For office use only Permit no. + ; Date ' 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. .� Est.Cost Type of Work• £�� z � r Address of Work:— Q Owner's Namelf--I P Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. BuiIding not owner-occupied Owner puffing 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 p rm' as the agent of the owner: Date Contractor Name Registration No. OR ; � Tllc• CU111111Ur111•Culth of aflussucbuscttr pc p irtlyze"1 of Iudirstrial Acc deters Office ofl/Nesrigzaaffs •�\ 71:i:�: 600 11*u.vhin,,,,twY Street Bti-vit t.Mas . OZIII Workers' Compensation Insurance Affidavit ii an inf rm iori• Pi P R I NT ^ Ct ncati n- �j I am a homeowner performing all %4ark myself m a sole proprietor and have no one working in any capacity I am an empiover providing workers' compensation for m% employees worf:ing on this job. cnntn•rnv nnme- adtlrrcc• tilt nhnnc#' , incnr-inrc rn noiicvt! I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who the following workers' compensation polices: cmmrintr.• nnmc- 1(lrlrrcc• tin nhnnc+�• in,mrnnrr rn Holier _ _ cmmn•tnv nntnr- nfldrrcc- tiny• nhnnc�• in-mrznce rn neiie�• __ Attach additional sheet if necesiarv�- 7. 7t "� -yam - -'~r•��~��~ - ��W��` w " Fnllure to secure cuvcrn¢r as required under tectton:SA of NIGL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andiur unc t cars' imprt.nnmcnt a.% t•ctt as civil penalties in the form 0172 STOP NVORK ORDER and a fine of S1day0.00 a day against me. 1 understand that a cope of this.N(atet»ca , t be fur„•nrded to the orrice of Investigations of the D1A for coverage verification. 1 do hercbr cerr' tier etc pt ' s if ell !ties of rjun•that the information provided above is true and correct Si^_r aturc � Datc Print name c o J n `(� &� Phone>* `� / Q 1otTicial use unI du not,write in this area to be completed by tiny or town ofrciai �• tin,or tn,rn: permit/license d r•tl3uilding Department CLiccnsing!hard L thee!: if imrnediate response is required Q Scicetmctt's Urrcc t ►. L111cailh Department r_ contact persan: phone it• rtUlhcr information and Instructions Massachusetts General Laws chap ter 152 section 25 requires all employers to provide workers- caiii lrensatian For employees. As quoted f con the "1a��'". an emphurer is defined as every person in the service of :uuitlicr under::rt% contract of hire, express or implied- oral or-written. An tunploYe is dcfned•as an individual. partnership. association. corporation or other legal entity. or ati%` t%%-o or the foregoing cn�saged in I joint enterprise,'and including the Ie_al represcntatives4a dcccasctf employer or the recciver or trustee of an individual , partnership. association-or other legal entity, employing employees. 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 divellinu or on the _,rounds or building appurtenant thereto shall not because of such employment be deemed to be an empic. MGL chapter 152 section ,5 also states that evert- state or local licensing agency shall wititliold the issuance Of- ��al of.a license or hermit to operate a business or to construct buildings in the commomvealtli for sny icant who leas not produced acceptable evidence of compliance with the insurance coverage required. A0L�.:ionally. neither the commomvealth nor any of its political subdivisions shall enter into any contract for the perform:.:ice of public wort: until acceptable evidence of compliance with the insurance requirements of this chap:-: been prez,—nied to the contracting authority. Applic:2nts Plc2se fill in the %vorkers- compensation affidavit completely, by checking the box that applies to ;your situation �i,� suppivin`= company names. address and phone numbers as all affidavits may be submitted to the Department of industrial .-accidents for confirmation of insurance coverage. Also be sure to si gn and date the affidavit- The Javit should be returned to the cin, or town that tite application for the permit or license is beinc requested. r :he Department of"Industrial ,-accidents. Should you have anv questions regarding the "law" or if you are requi-: o obi-in a workers* compensation polic}•. please call the Department at the number listed below. Co- or Twins Piec-e 7e Jure that tite affidavit is complete and printed legibly. The Department has provided a space at the bottorr. t12e :!"davit for you to fill out in tite event the Office of Investmations has to contact you regarding the applicant. P'. be _ : to-full in the permit/license number which will be used as a reference number. The affidavits may be returner "ie Deparnnent by mail or FAX unless other arrangements have been made. The Office of Inyesticatiot s would 1 ke to thank v6u`in advance for you cooperation and should"vou have an'y quesr;c please do not hesitate,to\__ive us aIczllr � ' y The Department's address. teiepiione and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Ma. 02111 fax #: (6I i) 727-7749 nitunc =. `6 i-) -,---'900 exr. 406. 409 or 7 . ,. "... • . � t✓�ie �ammwouuea� a�✓�aaoac%uaelta (F DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Na�ber - Expires: Restncted'To: 00 s VICTOR J NIINIKAINEN COMMISSIONER Wool 69 'I BARNSTABLE, MA 02668 ow mi �'k✓Ae IOYNht7R0 tip., HOME �MPROYENENT NTRA . y;�fegist at• rt�kO0053 a:s ,a�.��'r'�z.� IUIDUAL a xy . IC�OR fir: INIKAINEN as .Rd.'6 �t" yh. *nwf, FsF,a n�,a `a- ff•+.:'�",.-;E a'$5t F t- . AD-MIN�1R�T�OR�4��'�'Kc�e a '� � ,{''? a�iJt Ike• ngineering Dept. (3rd floor) Map - O 3 6o Parcel = 613 Pefffiit# House# Date Issued Y, a Board of Health(3rd floor)(8:15 =9:30/1:00-4:30) Fee. e` 9 7 Conservation Office(4th floor)(8:30- 9:30/1:00,2:00) F Planning Dept.(1st floor/School Admin. Bldg.) THE'Oj'�' Definitive Plan Approved by Planning Board 19 i BARNSTABLE, fc s9. TOWN OF BARNSTABLE, Building Permit Application Project Street Address Village co l C t Owner !C�7 +t `L ���� �' ZC Address ���� ���!t Telephone ? Permit Request 196® First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family QT Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes do On Old King's Highway ❑Yes 4; 0 Basement Type: ❑Full rawl ❑Walkout ❑Other 1 �� Basement Finished Area(sq.ft.) -Y0 4" Z Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 5 New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including Baths): Existing New First Floor Room Count Heat Type and Fuel: 46<as ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)�,�/' tached(size) '2. ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name it'll F ell Telephone Number Address rp J V tiVIR V License# Cd Q L) (CC C (y Home Improvement Contractor# 4 Worker's Compensation# �O N NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �� C U Z491PdD — cc, SIGNATURE S � DATE �T'� � • BUILDING PERMIT D IED FOR THE FOLLOWING REASON(S) 1 ^:v FOR OFFICIAL USE ONLY _ PERMIT NO. DATE ISSUED MAP/PARCEL NO. — ter✓+ � , `^ � �',✓. ` �F. ^\ _ t .., , • �w lo- ADDRESS T � ^.' -'� VILLAGE- OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION ,FIREPLACE ELECTRICAL: ROUGH FINAL` PLUMBING: ROUGH FINAL GAS%, ROUGH FINAL- FINAVBUILDING ! / 1 DATE CLOSED OUT. r, i r `� :Y. '. �, . �'•, E i ASSOCIATION PLAN NO. 'f 4 r' y' . i� The Town of Barnstable e MAMMM Department of Health Safety and Environmental Services 659. Building Division ! 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commission For office use only Permit no. Date 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• 1�f, ®�pv- �' ��� C Est.Cost ? r Address of Work: Owner's Name P1 fX R 0 Date of Permit Applications 9, I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. 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 15 PROVEMENT 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 pe it the agent!f the owner: Date Contractor Name Registration No. OR 'I �' '•-�{~ +�`�� Tlrc• Cunnrrun f+�ctrltlr of:1lassuch usctts It ; . ! Department nt of Industrial Accidents 1. office of/nvestfgat/ons ;� 600 11'ashingtun Street Bustin ,. a.u. 03111 _ ` Workcrs' Compensation Insurance Affidavit i li 'in inf•rm inn•- —. PIi P -- --�,�......._.^"•"'.-_........•._.____—�___-__ --_ _ Incetion I am a homeowner performing all work myself am a sole proprietor and have no one working_ in any capacity [I I am an emplover providing workers' compensation for my employees working on this job. 1room tny n:tmc: atldress• city phnne#• insurance co. nnliry 0 [I I am a sole proprietor, general contractor, or homeowner(circle on tra e} and have hired the conctors listed below who have the following workers' compensation polices: comnnny nnmc: 1tl tl rCSc' phone#- insurance ro. polio•0 cmmtianw name* acldresc� tin phone#- insurance co policy 0 Attach additional sheet if necciiL—ry- --+�• _'�" %•�""= �-�-•• ti—r-� =�••�'- —•—^ Failure to secure coverage as required under Section 25A of AIGL 152 can lead to the imposition of criminal penalties ol'a line up to S1.500.0U andiur unc scars* imprisonment:ts Weil:ts ciwii penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a dad•against Me. I understand that n cope of this statement ma% be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereht•c• ift•under t r pains and pcnallies of perfun•that the information prorided above is true and correct. Sianature ( ~ - Date Print name !�l C e�, �rP`1 � C� t� Phone# C 9d ofliciai use unl% do not twrite in this area to be completed by city or town official city or town: permit/liecnsc# rtfluilding Department Licensing Huard [• I] check if immediate response is required aselectmCWs Office ►_ otimith Department contact person: phone#: rtUther s, Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all ern plovers to provide workers' compensation for th.- employees. As quoted from the "law an emploree is defined as every person in the service ot,anodler under any contract of hire; express or implied. oral or written. An enrplotcr.is dcfincd'as an indii•idual.•partncrship, association. corporation or other.-legal entity. or anv two or MC.- the forcuoinu'crosa cd'in a,joinVenterprisd. and including the legal representatives of a de'ceascd cuinplover, or the receiver or trustee of an individual , partnership. association or other legal entity, employing employees. However owner of a dwelling" house haying 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_ Inc or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an empioyle, MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or reneival 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. 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 :-. been presented to the contracting authority. Applicants Please fill in the workers'.compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of industrial Accidents for- confirmation of insurance coyeraze. Also be sure to sign and date the affidavit. The affidavit should be returned to the cite or town that the application for the permit or license is being requested. not the Department of industrial Accidents. Should you have anv questions regarding the "law' or if you are requires to obtain a workers' compensation policy. please call the Department at the number listed below-. . City nr howns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom o: the affidavit for you to fill out in the event the Office of Investigations has to contact you re`arding the applicant. Pie: be sure to fill in tine permit/license number which will be used as a reference number. The affidavits may be returned Fie Department by mail or FAX unless other arrancements have been made. The Office of investications would like to thank`'�ou in advancccf-r you cooperation and should you•have ah%qu stior please do not liesitate to `_ive u"s a gall. . .. (. _ \ tom._.. '�' \' � .. 1?�`~ . .�... _ .. .. ....ten. ., _ • .. � _ .. .. :`j'. .�:ic• Tile Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of investigations 600 Washington Street Boston, Ma. 02111 "`> _• fax #: (617) 727-7 749 phone =: (617) 727-4900 ext. 406. 409 or 37S . , -'; � ^�1e .�a„emauoealA�i•o�✓�aaaac%uaetla �,. .. � '. DEPARTMENT OF PUBLIC SAFETY k: CONSTRUCTION SUPERVISOR LICENSE i. Nuber.. _ ::; Expires: �d w D OICTOR J BIINIKAINEN COMMISSIONER. p0.BOX 69 B BARNSTABLE, MA 02668 � I r ;'�' `� ��< ME IMPR,QytltEt4j ,NTRACTOR �' A� VIINIKAINEN Juniperd ; it. s .j n 936 Parcel Permit#,: Conservation Office(4th floor)(8:30-9:30/ 1:00-T2:00) ji c Date Issued C_ d Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) C/ S ,lZe,,�7,d 1,Fm) '. Fee' �� • Engineering Dept. (3rd floor) House# �tMF �. Planning Dept. (1st floor/School Admin. Bldg.) BARNSTABLE. . P Definitive Plan Ap d by Planning Board ; 19 t l MASS. TOWN O�F BARNSTABLE ;t Building4Permit Application Project St/re �'29 ��i s�� Street Address Village ` 0 v i d 5 J ,+. Owner Rir 9A m /9 LJ £ Address S�, � CC �a p Telephone- C> la �^ �� / o e a� :3 • Permit Request 7 Z dAf C5 lSlYr F K/'s rl;C'C k t'L C'l4e /YAO�C/!�� �C'�CO 0 V 2 `First Floor Z6 5 square feet Second Floor square feet Estimated Project Cost $ ( d Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use J;lH G G IL < ?/tt f L Proposed Use LWI'�'t!E Construction Type WO O 9 Commercial Residential !� Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure`005 r2 Basement Type: Finished Historic House Unfinished Old King's Highway ,Number of Baths No. of Bedrooms Total Room Count(not including baths) 1' First Floor Lx::7 Heat Type and Fuel ®1/A 11 (S-15 Central Air ,VO Fireplaces evd Garage: Detached Other Detached Structures: Pool /VIC Attached Barn /e c� None Sheds �= Other ® V1�7t_ee Builder Information NameI `CAL Ll`F Telephone Number rcA 0 /61®—,;;;" n Address 19 40 License# 0 0 ® / l ` l�•P y! C�' �- 0,9 ( "3 �77 Home Improvement Contractor# /® a O Worker's Compensation# /VG IV S NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �y�`C/dG SIGNATURE :7DATE ' -/�— BUILDING PERMIT DENI FOR THE IFOLLOWING RE Awr l f, FOR.OFFICIAL USE ONLY PERMIT NO. DAT'E'ISSUED k r M P!PARCEL NO. ADDRESS _ a f VILLAGE OWNER s - DATE OF INSPECTION: FOUNDATION a-' '—;) FRAME " INSULATION �"1c^�F. ,r - s .7; : . FIREPLACE ` ELECTRICAL: ROUGH f FINAL PLUMBING:, ROUGH ` FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT !ASSOCIATION PLAN NO. THE r � The Town of Barnstable MASS • s�uvsrnstE. • 9ebA �m�' Department of Health Safety and Environmental Services rEc►�ox" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date 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: 9C— Est.Cost 7 v j 0 Address of Work: � P Owner's Name A V-- Date of Permit Application: cot — /OCIL —1 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 he eby apply for a permit as the agent he owner: Date Contractor Name Registration No. OR Date Owner's Name Tile Cnnttttonit•calth of:1lassachuscin • w i .•.i uni ;� �.;w Dc parnyient of Industrial Accidems •. a ;. � � 0lficeollnivest/gatlons 6011 ff'ashin;�tun Street •4-••��•�•��.�' Boston. ,')lass. (IZIII �• Workers' Compensation Insurance Affidavit •t t r t n. - ._..- - �Cqinn* V ✓ U a �j cin �-�/� C���f��� ��`�. d nhnnc v / ® � 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working_ in any capacity I am an emplover providing workers" compensation for my employees working on this job. cnntn•tnv name- •tddretc• city• nhnnc tf• incur-ince cn nniicv I am a sole proprteto general contractor r homeowner(circle one) and have hired the contractors listed below who n theolices:foilowtn_ workers compensation p cnrnn•tnv n•ttnc• C �X/� •trldrets• � phone ir• 3 incurinrc rn _ 1 •r•*-_ _ yam•.�.-.-- '�•LT• -- r - _ _r -�..�.ZL•T TS•►.wy. .TT•_-1 • �i�r_`••_i�.�� /70 cnntn tn. nhnnc• C/® S atldre�c•l J J�f / / � /�® AA rite• ;��/�! /�/ I f O/ hone#!,�70 b ® O i curance c ���< ��'I J eii •a � �� Q® �� � Attach additional sheet if neceisa :..,-'•': _^-= I! i y."�: _ r--"_•,.... ••���-�.�*.wa ��:���� a..._..•..�.�� Failure to secure cuveraee as required under Section 25A of 51GL 152 can lead to the imposition of criminal penalties of a line up to SI.500.00 andiu. one v cars•imprisonment as well as civil Penalties in the form of a STOP WORK ORDER and a fine of a100.00 a day against me. 1 understand that cope of this matement may be fonvorded to the Office of Investigations of the DIA for coverage verification. I do hereby cent/&I &, /rc pains d caa1. * o prrjun•that the information prof ided above is t arid comet. � � l Si_natum Print name �<' ( ���/r Phone# 7 ' 01*0621 use univ do not write in this area to be completed by city or town official *� city or town: permit/license 0 r•1Building Department ` aucensing Board I] check if imincdiate response is required OScleetmen's Officc rIllealth Department �' Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers, ccnnpensation employees. As quoted loom the "1a��".an e»rploree is dcfincd as every person in the service of another under contract of hire, express or implied. oral or written. An emplitrer is dcfincd as an individual. partnership, association. corporation or other legal entity, or ally two , the foregoing enuaged in a joint enterprise.and including the lega1 representatives of a deceased employer. or t receiver or trustee of an individual . partnership. association or other legal entity, employing employees. Howf owner of a dwelling house having not more than three apartments and who resides therein. or the occupant of t. dwcllin- house of another who employs persons to do maintenance , construction or repair work on such dwell or on the _;rounds or buiiding appurtenant thereto shall not because of such employment be deemed to be an en MGL chapter i�:' section :5 also states that e1•ery state or local licensing agency shall withhold the issuancf renewal of a license or permit to operate a business or to construct buildings in the commonwealth for art applicant who has not produced acceptable evidence of compliance with the insurance coverage required nor an.• of its political subdivisions shall enter into any contract for thf. Additionally. neither the commonwealth .p til acceptable evidence of compliance with the insurance requirements of this ch: pertormancc of public work until p p been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situatioi supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Th 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 re to obtain a workers' compensation policy. please call the Department at the number listed below. City or•howns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bot the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant be sure to fill in the permittlicense number which will be used as a reference number. The affidavits may be rem, the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any qt: please do not hesitate to give us a call. ►!..'J-Ya-.�..- ..•-_.�•.Vs.+,• .�.�f..Tw.t4�Y•�.M—!1+.I�....�wr�.�..�..�w� ... ►4. . ,•. . w ��T1p.t The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents _. Office of Investigations 0 g 600 Washington Street Boston, Ma. 02111 n!t J= :: HOMER H. 8 ELOISE G. NEILSEN se7s�-� w 14.0'± 26.1'± Jp G�3 C _ y D Z Cn p q • m �,���4 ' 18066±sf Ilk CA govS £ „ �-yIS _ 4 H .' I - AL 3� i � 3 WO �1? '4► /�e4.�e�c R s R �c �1i9 R� �c,t � �� �l f® ©vRQYop Carts Z7 a Kt o V19 TI®� t-oirft DOSS 1 I ` O 0 ,�• rr — - -- — ——--- — ------ Q4­97 !c� 43 '�a- -- � --,.. � �2 x l 2 1�04 l•' t �. (1 S / G� O.� �ca C c� t�L d��.� . S c o t� F, t� � •. i ( a i m 47 r. ILI- u I/d Ay SOS e/ I Ole Ac.) i / f Vo4C r )® , O 4LJ i/z/ ,�r3 ���55 GLf s f 1A 710 s pFVEL j'I ® u --- s rmlNG gyp... _ -- �e ,a�3-•t 4 - I i '3' ctPes fr 1 a Flo t��t !o r! J►1 t� l 6L /4� ASK f 7�rll(5 14 er viL a 1 / � %SS/O z lie o -Zo' -- tr � 9 q t it LL II � - I - - ji; ��!e yF rr ��l`•^o�/�1 is�r /s .I CAL vv 774//s oil _,s I r!�+�� �co�•��? eta � L� - / �; g®19rke", 06 tz FT IT - - Ir Ki y s fi }e e �T �-. � _ _ •�!�� ��� �I C��T��°"_-..-,-A�'�'�Sc i�a4a:°L"' w w rr _ aw "f':.>�e.. - .. - ,_ i. ., 21_ - •.--•— �� •- ter r _ zol OL - ' ''.. 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A! - .__...,,-tF►,1.�.,�,-�-�---- � , eUVEM , central conskudion cam bk* " q Yf pp Steve Devlin ftF71' BodldbV- 820 MAin&rent•Cotutt.MA-608-420-1 0 -mail:come twnstru eil.Oirn Wobsits:www^eentralcapa►wnstruation.6orrr , T -__V_—• _ t' SCALE t-� - 0 rE DWG N0: DESIGN CHECK DRAWN . e •N e .. .. - PROJECT TITLE ir • � ______ ILe_t o c�-r •- f _ - - - tvi i4- ia : rt- �.( . -. 1 f€ tE jpP- it PRE PARED FOR .. ° ' .._._.-_. �,n,may -+ems'?' -iF s:.a•' ;.'zr7",: -Yr-: ...' � ';i - f } I { � i f 0 4 • f )-,L-T - Centel conshXtion company, In i Steve Devlin•President"The ExtafteiWent is BaUdWg" e20 Main street d cotun �a.' A®s08-420-i340 __..... : �, � � ! �-rv►�ii:c�ntrui �truan tnati. Webslta:www.centratea notruction,com SCALE?141% l 11 o BATE t S AS DWG NO, DESK CHECK F DRAWN _I JOB t}O SHEET OF TORN OF BARNSTABLE dF�*Yeeegy0 Dill ll 10 t r