HomeMy WebLinkAbout0182 MARINER CIRCLE �,
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Town of Barnstable
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Regulatory Services g �Thomas F. Geiler, Director
Building Division
BARNSTABL.E, Tom Perry, Building Commissioner
MASS.
1639. �� 200 Main Street, Hyannis, MA 02601
ArFD �a www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
TOWN OF BARNSTABLE
SOLID FUEL STOVE PERMIT
40-
Owner: B e 7 r L 1q 'Fie44ce' Phone: 7 7V 0.23 o-1
Install at: h�/}2,7de 0,pC t P Village: C %L,i % AIM
q
Map/Parcel: Date: 1-�Iq go-
Stove
A. New /Fjse
B. Type: adia / Circulating
C. Manufacturer: iQ A LA Y41 —T Lab.No.
D. Model No.: '
Chimney
A. New/ Existing (If existing, please note date o last cleaning)
�v
B. ue Size o a
C. Are other appliances attached to Flue?
Dire- a �and Manufacturer uL
E. Masonry: Lined nlined {�0" sC�sp�e /zipt1
Hearth
A. Materials: p 'It/(2AlP4T-
B. Sub Floor Construction:
Installer LA F Pew nVc
����� _
Name - - 6 A ROegpICe Address: :26V /u�7- 4olek"SZntMi'll
Phone: SSU �— --
Location of Installation: /3A e h�lPr,l�
H.I.0 Registration#
Construction Supervisor#
OR check X Homeowner Installing, no license required
APPLICANTS SIGNATURE
r!^
APPROVED BY: Xq7- /f 41 m
Please make checks payable to the Town of Barnstable.
*This constitutes an official stove permit after inspection, photographed, and approved by the
Building Inspector
Q:forms:stove
Rcv 103107
i
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
' 600 Washington Street
Boston, MA 021I1
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print LeLyibl
Name(Business/Organization/Individual): 7 a
Address: A.
City/State/Zip: Phone.#: 6 s- `e
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ 1 am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
.2.❑ I am a sole proprietor or partner-' listed on the attached sheet. T. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑Building addition
[No workers'comp.insurance comp. insurance.$
required.] 5. ❑ We are a corporation and its '10.0 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
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.
xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.M 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 ccertify under the pains an penalties of perjury that the information provided above is true and correct
Signatur,x
Date: -,2 Q O
Phone#: oC �I
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an 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-contractors)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 _f city or
town).".A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax# 617-727-7749 c.
Revised 11-22-06
www.mass.gov/dia
i
Town' of Barnstable
Regulatory Services
RAMS.,BL : Thomas F.Geiler,Director
�b 1 .•� Building Division
PrFD �A Tom Perry,Building Commissioner
200 Mairi.Street,.Hyannis,MA.02601.
www.town.barnstable.ma.us
Officer 508-862-4038 Fax: 508-790-6230
HOTSIEOWNER LICENSE EXEMPTION
/�
n / Please Print
DATE: M d Re 14• "/ c)
�JOB LOCATION: / , / . / A I
number / n street village
"HOMEOWNER": � ��II h { LM it ce /re?y ' -1 39 t Fr S—b
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 coast mcts 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.
X '
Signature of Ho owner
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_(Scetion 1 D9.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a pmon(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 assuring 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 responnbilities of a Supervisor. On the last page of this issue is R.form currently used by
several towns. You may care t amend and adopt such a form/certifrcation for use in your community. f
Q:forms:homcexempt
1
Town of Barnstable
Regulatory Services .
� AelRN6TesLE. �
n.as. �. Thomas F.Geiler,Director
16 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 ProP e Owner Must
Complete and Sign This Section
If Using A Builder
I, er of the subject.property
hereby authorize to act on my behalf,
in all matters relative to work autho ' d this building permit application for:
( dress o ob)
Signature of Owner Date
Print Name
If Property Owner is applying for permit pleas =rse
th
Homeowners License Exemption Form o e ree.
Q:FO RMS:O WNERPERMISSION
* ermit#Town of Barnstable P 7
O� Expires 6 months from issue dale
• s
. ,AMST"M r Regulatory Services
9 1659. `0� Thomas F.Geiler,Director,
.Building Division
Elbert C Ulshoeffer,Jr. Building CommissioneX-PRES SS' PERMIT
367 Main Street, Hyannis,MA 02601w
Office: 508-862-4038 O C T 2 3 2001
Fax: 508-790-6230
EXPRESS PERMIT APPLICATIONTOWN OF BARNSTABLE
Not Valid without Red X-Press Imprint
Map/parcel Number 7J3
Property Address_ KZ
E�, esidential OR ❑Commercial Value of Work stlad a"
Owner's Name&Address el
Contractor's Name s / � Telephone Number
Home Improvement Contractor License#(if applicable) /Od 2/O
Construction Supervisor's License#(if applicable) (�,507 a 7 L/ 2
FiWorkman's Compensation Insurance
Check one:
I am a sole proprietor
I am the Homeowner
[]have Worker's Compensation Insurance
Insurance Company Name Zkj r i C Al -r-1 C a j�l
Workman's Comp.Policy# (d f j 02 7-9 F(, UOU
Permit Request(check box)
Re-roof(stripping old shingles).
Re-roof(not stripping. Going over existing layers of rood
Fj Re-side
Replacement Windows. U-Value (maximum.44)
Other(specify)
'Where required: Issuance of this permit does not exempt compliance with other town deparunent regulations,i.e.Historic,Conservation,etc.
Signature!61 Ll / ci—
expmtrg
! yQ IM('T�`
•�' , The Town of Barnstable
rut JA vas : Inspection Department
� r. �
367 Main Street, Hyannis, MA 02601
508-790-6227 Joseph D. DaLuz
Building Commissioner
December 23, 1992
Mr. Roger A. Goodspeed
P. 0. Box 2 -
Osterville, MA 02655
RE: C182 Ma_finer_Cirele-, Cotu t-
A024 142
Dear Mr. Goodspeed:
The foundation at the above location is a hazard and
must be secured. To do so you must secure the bulkhead
opening to prevent access.
Please contact this office immediately re the above
matter.
Very truly yours,
Alfred E. =artin
Building Inspector
i
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LOC CrRCLE TDSJ .20o CT KEY i i 1-1 4-:91 9
----MAILING PCP 110 411 PCs
i J00 Y R..r oc, P ARE N IT 1 0
GOODSPEED, ROGER A 9 MAP a ARE,A].11BC W] f
GOOCISPE.'r"D, BARBARA C S P -T
0 COX .2 U T., 7 UT2,1 �46 Sn FTj
05TAERVILLE MIA 1612�653-k ,.,i y e EyBi or:,S G-,0 N. r 8,20"
0000 LAND 2.V.200 IMP OTHER 8300
----LEGAL DE SCRI PT Its 11 E ph'T 34500 RE ULAS FIED
2'6200 ASD IMP ASO OTR 8300
#LAND 1 .26,200 ASO LND
#OTHER FEATURE 11 8,300 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE
iPL 0183 MARINER CIR COTUIT TAX EXEMPT
#OL LOT 49 RESIDENT'L 34500 34500 34500
#RR 0q,781 0125 OPEN SPACE
,COMMERCIAL
N DUST RI AL
EXEMPTIONS,
-)51015 AFD7 SALEJ63183 PRICE-7 55000 ORBJ36'
LAST ACTIVITY].121171187 PCIR..TV
__ - - _
___
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C���2�t ./I.e` �'
9 0� � � ��
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CMIT
1 26 ,�9q� 64 HIGH STREET
l JU COTUIT, MASSACHUSETTS 02635
� LY ,
EMERGENCY PHONE: BUSINESS PHONE:
428-6526 428-2210
September 25, 1992
Alfred Martin, Building Inspector
Town of Barnstable
367 Main St.
Hyannis, MA 02601
Dear Mr. Martin,
Earlier today I received a call from Mrs. Terry Barboza of 68 Mariner Circle in
Cotuit. Mrs. Barboza indicated that her son had recently been hurt while playing
near the former Goodspeed property at 183 Mariner Circle. While we both
agreed that he did not belong.there, you and I know that "kids will be kids".
Mrs. Barboza expressed concern for the safety of her son and other children in
the neighborhood. I write to advise you of my conversation with Mrs. Barboza,
and to inquire if the property falls under the description of an "attractive
nuisance! I told Mrs. Barboza that I would advise you of the situation and that
you may be in contact with her in the near future. Mrs. Barboza can be reached
at 420-1590.
Please let me know if I can be of assistance in this matter.
Sincerely,
Paul A. Frazier
Chief
cc: Mrs. Terry Barboza
0
o
9,..1.... ...1.3 .S.ks§ks"a�r's map and lot number .... �.. /J n
!y /CXA` ��l-77.
Q
Sewage Permit number .......Cf....`.3 .........................:. SEPTIC SYSTEM
MUS •
AHBSTABLE. i
House number /.ga � INSTALLED IN COMPL.IA E•""ea �
s ,
WITH TITLE 6 �oway.a`em
TOWN O F B AR NWtIMCODE Arlo .
TIONS
BUILDING , �IN`SPECTOR
}-
APPLICATIONFOR PERMIT TO ........................ ................................................................................................
TYPE OF CONSTRUCTION � .. � �'
......� ...�..>�..�.. .��.........19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ...... ..... ..���.f.. !�Z ...G 1�L!i✓ :..:... .......:....:........:...
ProposedUse ....... ................... ...................................................................................................................................... .
ZoningDistrict ..........'. ......`.....................................,.............Fire District ............. ...... .....................................................
Name of Owner ... ..... ... (..�...;/-,.Address ......... .. r Gy�.�A................
Nameof Builder .... Address mil. ......... .................... ....................................................................................
Nameof Architect ..................................................................Address ....................................................................................
�Number of Rooms ...................................... ...........................Foundation .... ...................... ..................................................
Exierior .. ............................ e...............Roofing ...a,.. .. .................................
Floors !✓`� LL�...�� .........................................Interior ......... . .................................................
Heating , .�G.c� L �.........................Plumbing ��
�7 - -0,0
Fireplace .......... ............................. ...Approximate Cost .......
)3
Definitive Plan Approved by Planning Board ______19 Area .......1.�...1..Q...S........
.....
Diagram of Lot and Building with Dimensions___ _______ Fee ........®�v�
6. .............
SUBJECT TO APPROVAL OF BOARD OF HEALTH
11/f/7f
-------------
y�
r
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Nam ............................
Cedar &ormo Realty Trust
1 '
�o
° ,......?-1827 Permit for -..3.. ' .
1-in`~
~
-----------^-------^------- '
Location --' -.1.Q2-'merirmer'Rir.
.....................Catui�............................................
.
` .
Owner --'Cedar.'�wre&' ''�*vot'-'
. . . '
.
Type of Construction ----._.f��uoa----.
� '--------~.---.. --------
Plot /^�r. � ����p
---------. ^~ -~p --_-----.
' |
Permit Granted ............N0Y�......... .�--�]go?g
Date of Inspection . .. .. . ----]V
� ��
Date �omo �e6 . ���/������----lp
`
~ �
am gIRMIT REFUSED
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^ ..
---' ......................................................
���~ � .............................................
---'' ���� ~ /{
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.---.^'��.�....z. '�...----.--...-.-.-..
-�. �
---'' --'....�: ---^^`~^----~--'
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� � .��-----------. lq
Approved` Wf-'
-.-..----.�-----..-.-~.--....-.--
�
'
-------`--`^'------------^^^''
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Assessor's map and lot number .. ??.y...-.:. :.;. > .«.+. t •7
P
Sewage Permit number ....... .....
1 ^• Z SARNSTADLE, i
'House number ..........................1. E7�.............................:...... . y Mne6
�p 1639. e09
4 MOa\
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO _
TYPE OF CONSTRUCTION ....�/` � ....... '� !(�l?ti �1r..... .. ...................................
U ,
......�.�. ............ I .......19........
`. t.
TO THE INSPECTOR OF BUILDINGS: l
The undersigned hereby applies for
for a permit according to the
,following information:
Location ...... ..../ ..u. �/ 1..� �.. �.%.CAL;4-;:� - / ....:....:........:....... .... ....
ProposedUse ..... 1 ,� . ..................................................................... ...... ...... .....
Fire District
Zoning District ..........�... ........................................ ...........-........ "`'.:...............................................
• Name of Owner .. t ...... G� ......I.Address ......... ! ... .. ... ................
Nameof Builder ..��'' ' ...................................................Address ....................................................................................
Nameof Architect .......................Address ....................................................................................
(J
Number of Rooms ...................................................................Foundation .... 'G�%��
Exterior ,0�,j �C r^e� l(.><? ..:...............................
mot/ Cat a. Roofing r_ ���,
......... . ...................... ... .
Floors ��� .Interior —y..1'�/............ ..................................................................
GHeatingT ,,. ,....� Plumbing ........... I r
..................................... ...... ......................... .... �
Fireplace ....... ' ..... .............................................Approximate Cost ..........
¢... ...........
.. ........................
Definitive Plan Approved by Planning Board ------�9 Area ....... f �
...........
Diagram of of Lot and Building with Dimensions Fee ...
............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
j -
y3
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Ir
Name,.,., ..... ...............................
Cedar Acres Realty Trust
No?!M....... Permit for ...Lat.Q.ry..dwelling
...............................................................................
Location ....... I 2-Mariner-Cir.
................Cot.... ......................................
Owner ..... ...Tr.ust........
'tv Type of Construction .....X.an le..........................
.. ................................ ..............................................
LotPlot .................... ....... Lot ................................
Permit Granted .........N-QV ...1.3.......1979
Date of Inspection ........ ................19
Date Completed .......... 19
.................
P RMIT REFUSED
r
............... 11...�.4...... ....... ......... 19
....... ....... .... . .... .......................
............................................. .................................
...............................................................................
...............................................................................
Approved ................................................ 19
................................................................................
.................1,............................................................
„ •"” • TOWN OF BARNSTABLE 71�27"
Permit No. *"
Building Inspector
yauxnc Cash
� rua
OCCUPANCY , PERMIT Bond � 2l
No building .nor structure shall be erected, and no land, building or structure shall be `
- used for a new, different, changed, or enlarged use without a Building Permit therefor
first having been obtained. from the Building'Inspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."
Issued to Cedar Acres Realty Trust Address South Yarmouth
lot #126, 182 Mariner Circle Cotuit
Wiring Inspector 7 2x"O"
:.Inspection date 10L,
Plumbing nmeetor`t !` Inspection date
e
Gas Inspector 1-9 t Inspection date
Y Engineering Department �k1 � Inspection date
THIS PERMIT WILL NOT BE 9ALH), AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
j�Building Inspector.
.GOT /VO .11,6
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FOUNDATION LOCATION Z o
C O T UI T, MASSACHUSE T T S : z
owNE D e r .9C,2 tS �QEAL 7-/ 7-;e j-/- o z
SCALE "_4o DATE /Yv�'S'1979 Mae
J �[w uw `
NORMAN GROSSMAN----- — REGiSTERED LAND SURVEYOR z P z
Z `�'
Qp
I HEREBY CERTIFY THAT THIS FOUNDATION IS LOCATED A OF
ON TIE LOT AS SNOWN AND CONFORMS TO THE TOWN
OF 9ARIVST49LE ZONING REGULATIONS REGARDING MORMAN
SETBACKS FROM STREET LINES AND LOT LINES . " 00SSNAr y _
:A 12775 . q
4%
NORMAN GROSSMAN R.L. S. DATE Np 3U
ar