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HomeMy WebLinkAbout0140 OLD KINGS ROAD i i j a F8a 0- r Town of Barnstable *Permit# l Fxpires 6 m oaths from issue date Regulatory Services Fee 3wxxsTast.e; Thomas F. Geiler, Director 1��U v MAC J �P i634 a,� Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma.us �. 0ffice: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION. - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number C/ll;;� re / © 3 J Property Address / j Residential Valut.of Work Nfiai.mum fee of$25.00 for work under$6000.00 Owner's Name&Address I-1UI 4 7 V 0 JX7 A A Contractor's Name l' Aft�,K— Telephone Number Home Improvement Contractor License.# (if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor. X-PRESS PERMIT ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance OCT 1 3 2009 Insurance Company Name 1M - 1} TOWN OF 4 LE Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to � e /A ( PP g g ) _ ❑ Re-roof(not stripping. Going over, existing layers of roof) ❑ Re-side - ❑ Replacement Windows/doors/sliders: U-Value (rnaximum..44)' , *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 ontractors License is required. SIGNATURE: 1 n•,�zmcrr cc,cnoric, ,;1 F ;r f c c\FXPRFQC liar, 1 ' NOTICE Inv NOTICE TO TO . EMPLOYEES EMPLOYEES The Commonwealth DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washingt®n Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED INDUSTRIES OF MASSACHUSETTS MUTUAL INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE, P.O. BOX 4070, BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY 7' AWC 7016215012009 01/10/2009 - 01/10/2010 POLICY NUMBER EFFECTIVE DATES P O Box 494 Leonard Insurance Agency Inc Osterville, MA 02655 (508) 428-6921 NAME OF INSURANCE AGENT ADDRESS PHONE Mark Herbst 35 Peep Toad Road Centerville, MA 02632 EMPLOYER ADDRESS 12/23/2008 EMPf,OYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above ppmed insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the ser-.rices provided by the treating physician wiL be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby noted that the insurer has arranged for such attention at the NEAREST AND BE$T MEDICAL.FACILITY NAME OF HOSPITAL ADDRESS . ►'VTR O"wE ,ram 0�ie C�omirrza�zulaai ✓fGa4dactzu6r6 'i -\ Board of Building Regulations.and Standards i. License or registration valid for individul use only . HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration 126480 $ One Ashburton Place Rm 1301 Expiration 6/8/2010 Tr# 267766 Boston,Ma.02108 Type Indwidual ' MARK HERBST r' MARK HERBST (Y 35 PEEP TOAD RD r ' - CENTERVILLE,MA 02632 Administrator. Not valid without signature s Pik 8. rc 4 (TV j Construction Supervisor$License-'- f License CS 48546 �' } Expi anon 1127/201:Q. re* 14362 4 `3 Rest�cbon 00 14 MARK D HERBST r TOAD RD H << r i CENTERVILLE MA 02632 3 Comm►ssioner I The Commonwealth of Massachusetts Department of Industrial Accidents Office of fnvestigdtions 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electritcians(Plumberg Applicant Information ` Please Print Le 'bl Name(Business/Organization/FssdividuaT): �1�1L C� �'C��y • Address:- . S e�7 City/StatdZip: e�N� Phone.#: Ara yo an employer? Check the appropriate bwc Type of project(required): 1. I am a employer with _ 4. ❑ I am a general contractor and I 6 ❑New construction . employees (frill andlorport-time).* �vG wed the shb-contractors listed on thr, attached&beet 7. ❑Remodeling 2.❑ I am a sole proprietor or partner- Thcse sub-contractors have ship and have no employees 8. ❑Demolition employees and have workers' Buildingaddition working for uie in any capacity. � 9. ❑ . [No workers' comp.-ia&ux nGo comp_ra wince. 10. Electrical rc airs or additic required.] 5. ❑ We arc a cozporation and its ❑ p 3.❑ I am a homeowner doing all work officers have cxcrcised their 1 L❑Plumbing repairs or addi-tir Myself. [No workers' comp. right of exemption per MGL 12 i+f repairs incrnrance required.]t e. 152, §1(4), and we have aD 13.❑ Other employees..[No workers' comp;inetrrancc required.] *Any applicant that chrAv box#1 must also fill out the section bclaw showing their wori=ys'c0n`Pcruation poficy infmTmtion t Homcuwoc"who eubaut this affidavit indicating they arc doing xM work and than hire outside contractors must submit anew affidavit indieat�ng such- rCantractors that ebcck this box aunt adathed an additional sheet showing the name of the sub-antradum and&talc whether err not thosd cntitics have unployccs. If the sub--contractors love e�loyces,.theymuntpravidt thcir &veal='comp.pDliq number. I am are employer that is providing workers'camp ensatio rt insurance for my employees. HeCaw is the policy and job site informatYon. � � . . Instsra�cc Golx any Name: 1� '1 Policy#or Self ins.Lic.#--DbI 6d, .a Expiration Date- 1' ► `y"I (J rob sitc AdArms: Af E� 614 �K\ rA, city/stater7.ip: 0�(),It Attach a copy of the workers' comp 'on policy declaration page(showing the policy number and expiration date Failure to secure coverage as roquircd under Section 25A of MGL c. 152 can lead to the imposition of crinunal penalties of finer up to S 1,500.00 and/or ono-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a of up to$250.00 a day against the violator. Be advised that a copy of this stati-=rit may be forwarded to the Office of Investigations of the 17IA for' c v o crification. I do hereby certify d p of pegwy tha the information provided above is trues and correct. Si c: Datc: 3,716 O ficW use only. Do not write in this area, tb be compIded by city or town officiaL City or Tower: Permit/Lieense# IssrIIng Authority(circle one): I..Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Elambing Inspector 6. Other - yoFVEt, Town of Barnstable r r Regulatory Services ` uxxsres ass. Thomas F. Geile.r,Director. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section ff Using .A Builder r 14V 7� / l r� b�" , as Owner of the subject property hereby authorize UUl�4�'� `�-'(' to act on my behalf, in altmatters relative to work authorized by this building permit application for: (Address"Offob) O 6a. e o£ wner Dat Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Bar nstable �of THe ray Regulatory Services Thomas F.Geiler,Director f saxxsn.sr.E, MASS. q, 1634.. �� Building Division PTF1) Tom Perry,Building Comrnissioner 200 Main Street, Hyannis, MA 02601 www.town.b ar ns to b 1 e.m a'.0 s Office: 508-862-4038 Fax: 5.08-790-6230 —---- 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 strictures 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 pernst. (Section 109.1.1) The undersigned"homeowner".assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a parson(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption ai'o 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 homcowncr 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. A=022 092 � � �1ne- own or narnsia�re-� 1 )Al$Act- : Inspection Department i610 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D. DaLuz Building Commissioner March 31, 1993 Mr. George E. Balch, President King's Grant Association 40 Oxford Drive Cotuit, MA 02635 RE: A=022 092 Dear Mr. Balch: Enclosed please find a copy of a letter received by this office from Today Real Estate re the property located at 140 Old King's Road, Cotuit. If I may be of any further assistance please contact the office. Peace, J eph D. D uz uilding Commissioner JDD/-gr enc. 1252 Route 28 E �Lp So.Yarmouth,MA 02664 Office(508)398-0600 Res.(508)362-1570 Fax(508)398-0684 1T oday DAVID HOLT ir REAL ESTATE REALTOR@ r 1 REAL ESTATE March 8, 1993 Mr. Joseph D. Daluz Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 •x RE: A= 022092 140 Old Kings Road, Cotuit Dear Mr. DaLuz, This letter is to inform you that the property above had been modified by the former owner to allow a handicapped relative to occupy the property. It has never been used as a multifamily and the new buyers are buying it as a primary residence. If you have any questions regarding this, please call me. Yours sincerely, Djd . Ho lt tROR TOWN OF BAWNSTABLE DH:dlf BUILDING DEPT. Rp MAR 10 .190 U [ IVE Bell Tower Mall 1252 Route 28 1600 Falmouth Road, Unit 34 South Yarmouth, MA 02664 Centerville, MA 02632 (508)398-0600 (508)790-2300 Fax(508)398-0684 Fax(508)790-1388 �J= �aa-o9a 'yoaINC ro`` The Town of Barnstable ,.. : Ins 0": , I ,,,,, pectlon Department der►l' 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D. DaLuz Building Commissioner February 10, 1993 Mr. David G. Drake, Trustee P. 0. Box 6 Cotuit, MA 02635 RE: A=022 092 140 Old King's Road, Cotuit Dear Mr. Drake: This office is in receipt of an inquiry re the property owned by you and located at 140 Old King's Road, Cotuit. The King's Grant Association is concerned that the dwelling may have been modified to provide living quarters for more than one family. The property is located in a Residence F Zoning District and only single family dwellings are permitted. Please contact this office at your very earliest convenience re the above matter. Very truly yours, o,s' jph D. D L Building Commissioner JDD/gr cc: King's Grant Association Today Real Estate Town Manager E 1 r: t i R022 0921: LOC 0140 OLD KINOS ROAD CTY 01 TDS 200 CT KEY 11123 ----MAILING ADDRESS------- FCA 1011 PCs 00 YR 00 PARENT 0 DRAKE, DAVID 0 !RS MAP AREA 08CC JV NTG 2001 BOX 61 SPI SP2 S P uTi UT2 .61 SQ FT 2612 COTUIT MA 02635 AYB 1969 EYB 1969 OBS CONST 0000 LAND 35000 IMP 122200 OTHER 50o '----LEGAL DESCRIPTION---- TRUE MET 157700 RE CLASSIFIED QAND 1 35,000 ASD LND 35000 ASD IMP 122200 ASD OTH 500 #eLVG(S)-CARD-1 1 122,200 DESCRIPTION TAX YR CURRENT EXEMPT TAXWE #OTHER FEATURE 1 500 TAX EXEnPT #FL 140 OLD kINGS RD RESIDENT4 157700 157700 157700 #DL LOT 96 OPEN SFACE ORE 1154 0090 COMMERCIAL INDUSTRIAL. EXEMPTIONS SALE 041S9 PRICE 1 OPP 66971160 AFD I A LAS! ACTIV17Y OS116IS9 PCR Y RO..'32 ff92'. A F P R A I S A L D A T A KEY I I 1251 E)RAi.-.'E, DAVID G TR5 LAND BLD/FEAjrURE,--i BUILDINGS NUMBER ZFl/FL:::_RF 3-5.,000 i0o 1.22,200 1 A-COST 157,700 B-PH&'T 12 100 TaY (fi()/ BY /00 C-INCOME "cA=1 011 PC"=00 SIZE= 261 JUST-VAL 15 7 ("ONs I'll_C 0 -------COx'l'FARISOlN TO CONTROL AREA 08(,-,C TREND EX'CEEDS STANDARD NEIGHBORHOOD 08CC CO'JUIT PARCEL CONTROL AREA TREND STANDARD LAND-TYPE 35000 0 157700 ,r,r,Z4� IMPROVED-MEAN +43 , 25% FRONT-FT 100 DEFT IXWS TABLE 02 LOCATION-ADJ APPLY-VAL-STA'l I LNR LAND LFT1IMF ADJSISBIF-AT STR STRUCTURE ARR AREA-MEASV R E 11 �nTs 14OR No'i1E s COM nARYETI INC INCOME PMR PERMITS GRP 13RAPHIC FtibicT.ION- STRUCTURE--CARD NO 000 DATA- 117T 717- 1,ifg! The Town of Barnstable •► � Inspection Department 'SI Nil 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D. DaLtiz Building Commissioner January 15 1993 Mr. George E. Balch, President King's Grant Association 40 Oxford Drive Cotuit, MA .02635 RE: 141 Old King's Road, Cotuit 144 Old King's. Road, Cotuit Dear Mr. Balch: This office is in receipt of your inquiry re property e located . in the King's Grant development. p e Department has no listing for 141 or 144 Old King's Road.' Please furnish this office with a more detailed description of the property i.e. name of property owner or assessor's map and lot number. Peace, deph D. aLuz Building Commissioner JDD/gr I January 14 1993 ..40 Oxford Drive' . Cotu.it, MA.M0263.5 Building Inspector Town of Barnstable' . Town Hall Y _ E n Hyannis, MA 02601 Dear Sir : Enclosed for- . your ° in.format ion is a letter we are sending, to TODAY realtors relative to .property . for sale at 141 Old Kings Road in Cotuit . The letter is self-explanatory. - We are' requesting ,that youi investigate . this situation and. report to us as to whether this property has been modifed to provide - -living quarters for more than one family. We appreciate your cooperation and await your response . Sincerely, George E . Balch,.. President January 14, 7`1993, 40 Oxford Drive Cotuit, MA 02635 TODAY .Real``Estate Co . r 1252 Route •28 So Yarmouth, MA 02664 Gentlemen : We are aware that you are listing property. at,, 144 Old Kings .Road in King's Grant, Cotuit for I sale_.: It is our understanding that in the ,past, th-i5s ,property had been modified to provide separate kitchen facilities for a handicapped member of the family. We .are sure you are aware of "the Barnstablezoning regulations applicable to this property which permit sing.le .family usage only. You should also be aware of 'the. King's Grant protective covenants which are recorded in deeds f.or all lots -in K.ing'`s Grant and which also restrict occupancy to a single family. It had been reported to- us .that some repairs or alterations had been made at, 141 Old Kings Road recently, and we merely want to emphasize that any conversion for any, use 'other than a singill family. . "residence would, .-be a violation..:',,' f `both the. Town of Barnstable regulations and 'the King s Grant convenants. We, of course, 'wou-ld expect you to convey these facts • to any prospective purchaser and to advise the current bank owner of these restrictions : Very truly yours,, C, 12 C_� n George E . Balch, President /Cc : Building"Inspector Town of -Barnstable V January 18, 1994 f .40 Oxford Drive Cotuit;. .MA.'02635, . Building Inspec.torh Town of Barnstable Town Hall Hyannis, MA 02601 .. ' Dear Sir _ We regret the error in our recent correspondence to you re identification of .Qroperty . .on Old Kings Road in Cotuit The error in part .occurred because there' does not appear to be ;any street number on the building . However, we. have now checked with the Assessor' s Office and find it..'to be identified as follows : 0L :�1►JCr�" We also would"appreciate knowing' if -a variance "was issued to allow the construction of the existing second kitchen and -if so whether any conditions were specified, i. e . that it only be - allowed- for use of' the original applicant . Sincerely, George :E . Balch, President- FE17 $14..50 -' CIS TOWN OF BARNSTABLE, MASS - a 0 c 4 dune 26 1,9 M q M to 0.�, � THIS I S TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO « �� 00 4-lrah. Inc. �hquolt' Mae 1 O __....._.........._..............._...............__.__..._..._._....._"'"_.___.._.».»___ (PROPERTY OWNER) - (ADDRESS) N Build 1 1/2 story fra:ve duelling TO _.......... ...»....._.. __...�__ _ _......_._._._ :3 c)"" (BUILD) (ALTER) (REPAIR) :5%. 040 ay 6ingle family dwelling 1431 s,. ft. _ .._._......._......_.» OcaO (TYPE OF BUILDING) (APPROXIMATE/lZp a�A lot i 96 Old Kings Road Cotuit LOCATION g 16TR[ET AND NUMBER) (VILLAGE) NAME OF BUILDER OR CONTRACTOR �"mer Ds , 000 APPROXIMATE COST m w to as 0a E I HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN em 'U, OF BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION. BB0� ___.___...._....»............................... cs a - (OWNER) (CONTRACTOR) y co Xz6 BUILDING 114SPECTOR Subject to Approval of Board of Health. 0n,-, 92 <. .. v* r.' yr '?3 a,(Fs._ C')_ . F. i, !'•. � � � ... ACTION _. CARD CG��C� 3?��F. 111..�. 00000000 FERNT.s—pis, mo ;`R TvFE VAC:11E Cik—BY, NO YR % N.F l,.iEkT/;:'EM0 C,0MilxN .S