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0285 STRAWBERRY HILL ROAD
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Y-.. � , ��, - .. 4 yr: r L � • � � �.. .. � .. .. _ .,. } ,, .. ,. -. � ,. �i _ _ .. �. . . _ - ,. .. .� �. o .� ._. -� ,. _. ., u �.:.: e :. � �- n _ ,. :. � .. � .. � 1 - _ .. �� i _ '. � .. e:. .. a � a .. _ � � �. �� - ,�-v. .. � � �� h v _ ,: f ., . ,. . _. e: ., ,�.. ,. :. r r,,, ,, t� Town of Barnstable � ` � Shed Post This Card So>That itis Visible''From the Street Approved Plans Must be Retained on job and this" a'rd'Must be Kept l Posted Unt�I Fina) Inspection Has Been Made , Where a Certificate of.Occu anc is Re_wired,such,Buldm shall No'.t;be Occu ied until a Final Ins ect�on has been made Registration Registration Number: B-20-115 Applicant Name: COLLINS, DENNIS SR& PAMELA J Approvals Date Issued: 01/14/2020 Current Use: Structure Permit Type: Building-Shed-Residential 200 sf and under Expiration Date: 07/14/2020 Foundation: Location: 285 STRAWBERRY HILL ROAD,CENTERVILLE Map/Lot: 247-217 Zoning District: RB Sheathing: Owner on Record: COLLINS,DENNIS SR&PAMELA J Contractor Name Framing: 1 Address: 285 STRAWBERRY HILL RD Contractor,License: 2 CENTERVILLE, MA 026321; � Est Project Cost: $0.00 Chimney: �) Permit Fee: Description: 10'X16'SHED $35.00 - i Insulation: 3 Feb Paid:i $35.00 Project Review Req: 1/14/2020 Final: i, Date Plumbing/Gas _At JRough Plumbing: _F Building Official, Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months aftegissuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and st ructures,shall be incompliance with the local zoning-by-lawsrand codes. This permit shall be displayed in a location clearly visible from access street orlroad and shall be maintained open for public,mspection for the entire duration of the Final Gas: work until the completion of the same. - Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:i Service: 1.Foundation or footing 2.Sheathing Inspection ,. Rough: 3.All Fireplaces must be inspected at the throat level before firestflue lining is installed - 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered,contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: ' Town of Barnstable Building Department Services �I zo. Brian Florence,CBO �l ssLABLF� = Building Commissioner xess . 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma as Office: 508-862-403 8 Fag: 508-790-6230 PER yffr# - �', FEE: $35.00 SED D REGISTRATION RESIDENTIAL ONLY 200 square feet or less d b � � L Location of shed(address) Village Property owner's nanne Telephone number Size of Shed /Farce # 262-0 Signatrae Date Hyamus Main Street Waterfront Historic District? . Old King's Highway Historic District.Commission jurisdiction? _ You must file with,Old King's Highway Conservation Commission(signature is required) Sign off boors for Conservation 8:00-9:30&3:304:30 PLEASE NOTE: CIF YOU ARE WTTEON THE JURISDICTION OF ANY OF TBE ABOVE COMMISSIONS,TERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE TBIE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST U ACCOMPANIED BY A PLOYPLAN Q-farms-shedmg REV:08/6/17 _ Legend ` 1 � 0 Parcels ' Town Boundary rr.:::` •• r 22 Railroad Tracks S: :::: :#;27:'<.'r;; ;<::;':';:: '•'•;:;:.::::: #296' Buildings - :.:.:•: '.':: :i:;:!.•?.::•;.;;::::': :•::•: In Approx.Building '^'s.4 :..f•:;•...'^ ID Buildings _ Painted Lines Parking Lots 17 Paved O Unpaved ' •::::•.: ..... .... . ... ---.:z ,.° �'; Driveways • w EJ Unpaved '� ,� ••'=;��_:�:': Roads Paved Road . . Unpaved Road , ` ®Bridge p Paved Median 2418` '� —Streams Marsh Q Water Bodies 247217 #285 3 iL •. z 247218 247103 • �. �•N '� -. #2.75 #.286 ► a lines shown n re only gr aphic only.It is not Parcel e o this ma a This ma is for illustration purposes o >� p , Map printed on. 1/13/202o p P 1'P Y p Y Town of Barnstable GIS Unit adequate for legal bounds determination or representations of Assessor's tax creels The are Y 4 g boundaryP i, Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA o2601 0 21 42 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: cinch= 21 feet cartographic errors or omissions. gis@to wn.barnstable:ina.us ", TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map. Ic Parcel TOW OF 5 'RNST BLE Application # Health Division ?` a k. • 'j hi 0. ?""7 Date Issued 7 Conservation Division Application F r_ Planning Dept. ., aa�a. ��n®...�� Permit Fee XJ Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address DZ55_ 'Q�bf'1(�(U k-F,t LL V_WL Village f h Q_V�1t;1- Owner Dm'ms P -P fn CO :n S Address d%,l nboa be=M� Riul� Q . Telephonk,5bS) -7-75 --1 t(69 Permit Request Ca-av �L� Cu�,;Nk r� P,G Qa � "=i�\2 i.o c�L:S ��t{l N4 �3 n 7`iJ C©Ly� z4ZS [�A{ZtL\:�e��.C� Y'�aw3.5�.e� ^"t-�'L4 �'� A 3 a�C.� C'.� s� 1 �� � ��K-�0.�t-►`�+� Cam cc.' �.2v�s�-- lS �1rv�z�.,v ��� Square feet: 1 st floor: existing 116�proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation cro�,, lo410 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Famil o Two Family ❑ Multi-Family(# units) `-Age of Existing Structure \ -1 D Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ��Sf1YY1 CfZ Telephone Number Address (G(D C.of cNe 1 fir,Ve. License # C 3 01(o 511 �W I t,I tCM , MA Qa a� Home Improvement Contractor# Email �;L�=a l_ ��C�1e �S-� Worker's Compensation # Ak ALL CONSTRUCTION D $IRIS ESULTING. ROM THIS PROJECT WILL BE TAKEN TOWC5-36 ?GT904" SIGNATURE DATE {r ` FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. s { f t ADDRESS VILLAGE OWNER { DATE OF INSPECTION: FOUNDATION S ` FRAME r INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL I GAS: ROUGH FINAL FINAL BUILDING E DATE CLOSED OUT r ASSOCIATION PLAN NO. 308" 1.5 9 27" 36" —24" 33" —1621". 179" I 89 " 39 9" 59'" 179 a" 1 s J z177 3 12". 150TI" iIz SUO WB2736 NEW VENT W82436 i Pie " M B 18. D27.03"' WB3320.24 N ' aim M if; m _ REFRIG m MCO LO Ile 1COLe t CO C LL - . I r �rx!,3_-.j 246'' - ,. 11,6" 143 5 e„ — 5k"'C4 ocJ! 301 e, civs4cl tcO i s„Id.�., t 438, 75.8". 68 75� a`---458" k caclt 12" 296" 308" Al,l:dimensions.-size designations CAPE-ISLAND.KITCHENS This is an original design,and must Designed: 3/19/2016 given.are subject to verification on. Hyannis not be released or copied unless Printed:3/19,/201.6 job site and.adjustment to ft job 508-775-3664 applicable fee has been paid or job conditions. Michele Lincoln, CKD order placed. COLLINS,Pam and Dennis till Drawing#: 1. No.Scale: { _. << y : Note: This drawing is at!artistic CAPE.JSLAND KITCHENS Designed: 3/1.9/2016 interpretation of the general Hyannis. Printed:3/21/201.6 appearance of the design: It is 508-775-3.664 not meant to be an exact.rendition. Michele Lincoln,CKD COLLINS,Pam,and Dennis All Drawing'#: 1. i ----- - Note:This drawing is an artistic CAPE ISLAND KITCHENS Designed:'3/1.9/2016 interpretation of the.general Hyannis Printed:3/21YU16 appearance of the design.lt,is; 508-775-3664 not meant to be an exact rendition. Michele Lincoln, CKD 1 _ COLLINS, Parn and Dennis All J.Drawing#: 1 TLLt l Lo G,�f o - -- -- .�r L—I j Note:This.drawing is an:artistic CAPE.ISLAND KITCHENS Designed- 3/19./2016 interpretation.of the general Hyannis Printed: 3/21/2016 appearanae of the design, It is 508-775-3664 not meant to be an exact rendition; Michele Lincoln, CKD . COLLTNS, Pam and Dennis JAII Drawing#: 1. c, 11 � g. Note:'this.drawing:is an artistic CAPE ISLAND KITCHENS Designed: 3/19/2016 interpretation of the general Hyannis Printed::3%21/2016 appearance.of the design. It is 508-775-3664 not meant to be an exact rendition. Michele Lincoln,CKD COLILTN$,Farm and Dennis A11 Drawing#: 1 i The Commonwealth of Massachusetts Department of Industrial Accidents d I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia «"orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: City/State/Zip: A-i-0IZ- 5_z� M4 0))_60 Phone#: —2Z7� Are you an employer?Check the appropriate box: Type of project(required): 1.04 am a employer with 4�_ employees(full and/or part-time).* 7. ❑New construction 2. I am a sole proprietor or partnership and have no employees working for me in ❑ 8. ❑Remodeling any capacity.[No workers'comp.insurance required:] 3.�I am a homeowner doingall work myself t 9. El Demolition y [No workers'comp.insurance required.] 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole I I.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.M I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.� p Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. . 14. Other 152,§1(4),and we have no employees.[No workers'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: Policy#or Self-ins.Lic.#: t 5 — 31 > J /V Expiration Date: Job Site Address: '':� 5&M:K)1J /`�' City/State/Zip: 6JVVZ,_ / 0 -Cw, Attach a copy of the workers'compensation policy 4aclaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify deer th pains an penalties f perjury that the information provided above is true and correct. Si ature: L' ! Date: 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): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: trice of Consumer affairs&Business Regullion License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: of Consumer Affairs and Business-Regulation, -. egistration 460266 10 Park Plaza—Suite 5170 Expiration V_+j _6 Boston,MA 02116 �ci ;.y4 Cape&Islands Kitch�n&Bath QA deling Inc WILLIAM SCHMITZ t- 99 State St. .r.� '� �_ _.. Sagamore Beach, MA 02562 Uudersece "t Not valid without signature Massachusetts Department of Public Safety 19 Board of Building Regulations and Standards License:CS-076571 Construction Supervisor. WILLIAM L SCHM11 66 CARAVEL DR! HATCHVILLE M4._0 r - , �i Expiration: Commissioner 09/09/2017 308" 1.5" 9 27" 36" ' 24" 33"—�' •• -162," - 179" I 89 391" 9n. 59�,i e 179 B" „. 30,,10 3 27" 1 3 12' 150-1 -- Suo W62736 NEW VENT ' WB2436• LO ' PIS z. M B '18t D27.W WB3320.24 N "m M R.EFRIG Is I m r> LOM - 4 - CO J I 'S ® � Cq M M-----M. --'F--—m ...... .... .. .. .. .. ...... ... 5 M I LL ---------- ---" ---`— -- J —-- - .. _ - --- ---- - - -- 1,�- ( - ----- - _ ------------ - - .. _ TF a or -T I': LO C� atoewe.�\y J2, 16 1:8e' Q¢vLo�'cl w;l\ 301 e _ ,6 75;e" —68-" - 75A'��. _ 12" 296" 3081, A11.dimensions.-size.designations CAPE-ISLAND KITCHENS This.is an original design,and must Designed': 3/19/2016 given.are subject to verification on Hyannis not be released or copied unless Printed:a/.19/201.6 job site and.adjustment to fit.job 508-775-3664 applicable fee'has been paid or job conditions. Michele.Lincoln,CKD order placed. COLLINS,Pam and Dennis Ail Drawing#: 1, No.Scale: TF Note:.This drawing is an'artistic CAPE.J.SLAND KITCHENS Designed: 3/19/2016 interpretat-iori of the general Hyannis. Printed:3/21/201.6 appearance of the design, It is 508-775-3664 not meant to be an exact rendition. Michele Lincoln,CKD. COLLINS,Pam.and Dennis Drawing'#: 1. qI 0 i Tz IT l � 7 i - Note: This drawing is:an artistic CAPE ISLAND KITCHENS Designed: 3/1..9/2016 interpretation of the.general Hyannis Printed: 3/21/2016 appearance of the design. It is 508-775-3664 not meant to be an exact rendition: Michele Lincoln., CKD _ COLLINS, Pam and'Dennis All Drawing#: 1 L7 IL 0C-) ------------ Note:This:drawing is an:artistic N CAPE-ISLAND KITCHENS : Designed: 3/19/2016 interpretation of the general Hyannis Printed:3/2]/2016 appeararne of the design, It.is 508-775 3664 not meant to be an exact rendition: Michele Lincoln, CKD COL,L:IN.S; Pam and Dennis All Drawing#: 1 Note:'I`his.drawing is an artistic CAPE ISLAND KM IL-'NS Desigried: 3/19/2016 interpretation of the general Hyannis Printed.3/21./2016 appearance.of the.design. It.is 508-775-3664 not meant to be an exact rendition. Michele Lincoln, CKD COLLINS., Pam and Dennis All Drawing#::1 _ Pa Li ^1 fly Nv3 CAPE&ISLAND KITCHEN AND BATH REMODELING INC. 99 State Road, Route 3A Sagamore Beach, MA 02562 Phone: 5 -4 Fax: - 1442 Contract Date: 4-6-16 To: Dennis & Pam Collins 285 Strawberry Hill Rd. Centerville, Ma. 508-775-7169 508-284-3490 C# Den niscollins90(@_yahoo.com . Cape & Island Kitchen & Baths Remodeling Inc. will provide the following renovations as per plans provided. Included are as follows with respective allowances. , Plumbing: • Disconnect all existing plumbing fixtures in kitchen. • Cap pipes for clean installation of cabinets. • Provide new water lines and shut off valves: • Provide new pvc drain and trap. • Relocate water line for new frig location. • Disconnect and reconnect gas line for range. • Replace existing heat covers. • Supply and install new toe space heater. Electrical: w.� I grS-P LSO, • Supply and install [5] Xenon under cabinet lights. ca e641 ' • Supply and install a total of[6] 5" recessed ceiling lights @ $180.00 per light. • Connect all owner supplied appliances. • Provide all receptacles as per code. .G'F1's • Provide all proper circuits and arc fault breakers., Provide wiring for new toe space heater. • No upgrade to service panel at this time. Flooring: • Supply and install 3 W oak flooring. • Sand and refinish with [3] coats poly. • Sheen: Satin or semi?To be selected. ` • Supply and install new tile splash. • Tile allowance per sq. ft. $7.00 • Grout Once Sealer provided. General: • Provide all necessary permits..Fees included. • Provide trash container on site. • Remove all cabinets and tops. • Remove or relocate existing appliances. • Remove existing flooring and prep for hardwood floors. • Remove and replace baseboard moldings in same area as floor. • Remove all wallboard, trim and insulation on 1 sink wall and partial other to slider. • Replace insulation with Close Cell. • Blue board and piaster walls and lay over existing ceiling. • Ceiling texture: Smooth • Replace all trim to match existing. • Install owner supplied appliances. • Hood is self venting. No ducting to exterior. • No Painting Total.job::$22,640.00 Payment schedule: /~ • $5,000.00 deposit required upon signing contract. • $5,000.00 due upon completion of all demolition and prep. • $5,000:00 due upon completion of.rough inspections_ • $5,000.00 due upon completion of hardwood floor insulation. • $2,640.00.00 due upon completion of work. We propose to furnish material and labor in accordance With the above.specifications for the sum of TOTAL OF s22,640.00 In.the event that it is necessary to.pursue.any legal action to collect any outstanding balance the customer shall be responsible for the total balance plus all legal costs. ACCEPTANCE OF PROPOSAL:: SIGNATURE DATE Michael Heinrichs Project Manager 4-6-16 C#774-208-2362 .2416-08:11 a Cape& Island Kitchens 508-833-1442 p.1 DATE(MAUDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 71712015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(tes) 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). .CONTACT PRODUCER DOWLING & O'NEIL INSURANCE AGENCY INC NAME: 973 IYANNOUGH RD PHONE FAX PO BOX 1990 ALG.No.Extl: IAIC No): E-MAIL , HYANNIS, MA 02601 ADDRESS: IHSURERIS AFFORDING COVERAGE NAIC0 INSURER A: LM Insurance Corporation 33600 INSURED INSURER B: CAPE & ISLANDS KITCHEN & BATH REMODELING INC --- --------- — ---__- 99 STATE ROAD ROUTE 3A INSURER C: SAGAMORE BEACH MA 02562 ' INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 25487456 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. %JOTWITI-STANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY ThE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ---ADOL SUBR - POLICY EFF POLICY EXP _TA TYPE OF INSURANCE POLICYNUMBER MMIDDM MMIDD/YYYY - UPAITS COMMERCIAL GENERAL LIABILITY EAC-1 OCCURRENCE $ :LA.I.MS-MADE _J OCCUR DAMAGE YU - PREMIRES(Eaoccurrence) S MED EXP(.Any one person) S PERSONAL a ADV INJURY S - GEN'L AGGREGATE LIMIT APPLIES PER: + I I GENERAL AGGREGATE S OUOY 7 j C7 L06 '' _ PRODUCTS-COMP/OR AGO S CThER: --- AUTOMOBILE LIABILITY - CO a 31- bl— LE LIMIT $ — zagcJdent� ANY AUTO - i BODILY INJURY(Per persorl E ALL OWNED SCHEDULED BODILY INJURY(Peracciden) S _AUTOS AUTOS _ NON-OVVNED PROPERTY OAMAGE HIRED AUTOS AUTOS ]- i (Peraccidenl' S S UMBRELLA UAB OCCUR I 1 � � � EACH OCCURRENCE S EXCESSLIAB ; OCCUR AGGREGATE S CEO i RETENTION S 4 S A WORKERS COMPENSATION WC5-31 S-369904-025 71l/2015 7/3!2016 ,/ 'sEnruTE oRH- AND EMPLOYERS'LIABILITY Y r N } ANY PROPRIETOWPARTNERFE(ECUTIVE C:NIA E.L EACH A"CIDENT $ 500000 OFFICERR/FMBER EXCLUDE(' v (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500000 If yes,desc,be under DESCRIPT ON OF OPERATIONS below E.L DISEASE-POLICY JMIT $ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers compensation insurance ccverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 MAIN STREET THE EXPIRATION DATE, THEREOF, NOTICE WILL BE DELIVERED IN 200 MAIN STREET EET ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE LM Insurance Corporation LJ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD ZS4B7456 I 1 3c39C4 1 15-16 WC 1 A—e Ch—el— I 7/�/2315 12:3Bi53 P14 (=) Page 1 oC 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ` .Application # � Health Division Date Issued -, Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board - o9-7 Historic - OKH _ Preservation/ Hyannis Project Street Address JYrZU&J , Village � y��� Owner Itn/N/S �2��iNS Address 12,5" Telephone Permit Request Mboy7 Doa2 sV20p u//QOOG Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation onstruction Type Lot Size / Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 3 Two Family ❑ Multi-Family (# units) Age of Existing Structure Z v • Historic House: ❑Yes CI No On Old King's Highway: ❑Yes Wlo Basement Type: ❑ Full.., ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths:' Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count r` Heat Type and.,.Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other , Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: 0 Yes-O No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size__Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name S�a� Qyi� /L_ Telephone Number c dry 77/- alYl Address aY7 ShauJbf.�•c�, %� ,21 License# CS7 2000 3Z Home Improvement Contractor# /32 6g l Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 0 ,I/O FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP 7 PARCEL NO. ADDRESS VILLAGE l OWNER tij f �. ' • '- °� 4�`1 I 4 DATE OF INSPECTION: W , FOUNDATION QZ13eaos o 3110 f FRAME dim o!c di�/3�o h'/ lG 44 J INSULATION ' FIREPLACE *_ -7 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - GAS: ROUGH ' FINAL FINAL BUILDING (Q '313b)l o ° DATE CLOSED OUT ti ASSOCIATION PLAN NO. The Cominorrwea.Itri of 'IdssrichzisettS Department of Industrial,4ccidents, - t _ Office of 1,tVesdgalions ,600 wad hington Stree! Boston, 1l'L4 OZX11 �VFi W.771aS5.gov1d!a e davit: Builders/Contractor`s/EIectricia-ns/Ptulilb r Workers' Compensation 7ns>Yranc AppL>cant Information Please Prim Le-ffibLY Name (Business)DrganizRtion/Individusl); S eo tr Address:" Al � City/State/Zip: 014 3z. Phorit,-'A 77/'OLy� Are you an employer? Check the appropriate box: Type of project(requited): I.❑ l am a employer with 4• ❑ I'am.a general°contractor.and I 6."El New construction craployccs (LA and/or part-Gmc),*. baVc hued the stib-contractors listed on tbc`attachcd'shcct 7 Z R= doling 2.[� I am a`sole proprietor or parhlcr 4 Thcsc sub-contractors have g, 0 bcmolition ship and bavc no employees ' work5ng for me in any capacity. � cmployces and have �vorkci-s' "-9. _❑Building addition [No �torkcrs' comp.insurance co=P• insurance.t 5. [] We are a corporation and its 10. Electrical repairs or addttio r 'I'r�l _ otfacc'n bavo cxcrcised their 11_[]Plumbing repairs or addido 3.[]�I am a homcowntr doing`a11 work 4• : t of exem tion er MGL a myself♦ [No workers' com}s. n P p 12,E] Roof repairs c, 152, §1(4), and wo bayb no iner,ra nee regvircd] 13.El Otbcr . cmployoes. No workers' comp,insurance rcq�ired.7 'Any applicant thzt chtckr box#1=must also fin out the reckon below ghowing their workers eompcnsaJion policy infrnrration. t Homtawnti C who rvbmit this a$davit indicating[ficy oIt doing all work and thin hint outsidt cantraaiori mustrubmit a new zT vit'm,di cgiing such rContractors do t`eh=k this box =t atbMhcd mt additional rbett rhovring the Warne of f}ie sub cones tm t and rt1{c whether or not those tntidrs have employees. Tfthe,rub-contractors have cmploycer,they murt providb th6T workers'comp.policy nrunber. I am an employer Chrd is providing Workers'compensa wri insurance for my employees. Bela-,p-ls the policy and job safe t' Insurance Companyl'arne: Policy# or Sclf--ins. Lic.#: Expiration Dite:g Job Sitc Address: City/StatdZip: Attach a co of.the workers' compensation policy der-laration page (showing the policy number and expiration date) Py .. a - Failurc to sacttre covcmgo.as rcgturcd under Section 25 A of MGI c. I52 can Icad to the imposition of c�mir_ial peoa7ties of a find up to S 1,500,00 and/or ono-ycar imprisonment; as We11 as civil penalti'ts in the form of a STOP WORK ORDER and a fi of up to $Z50 1)0 a day against tho violator. Be adyis cd that a copy'of this stattmcrit may_bc forwarded to the Ogee of Invcsti ations of the UTA for inn amc covcra c vcritscation 1 do hereby certi nder the ains•urrd pen perjury tTtaf the irrfartnation provided abate'is true and correrf M Date. — Si u aturc: ?1 Phouc#: .1-V�I I Official use only. Do not virile in thu'area, rb be completed by city or townofficial - City or Town: Perntit/License# Issuing kU'tbor ty(circle one): l.�Board of E[calth 2, Building Department 3, City/Town Clerk 4, Electricad Inspector. S. Plumbing Inspector 6. Other �' e or ma ® end InstructIOUS M assachusetts Gcncral Laws chapter152 requires all employers to provide wockocfsnom p na r a y c ntra mlh"ces: Pursuant to this statute, an e,rtptoyee is defined as "...every person in the servre, express or implied, oral or written." artncrshi association;corporation or other legal entity, or any fw oor corc An errs In er is dtfincd m ,an individual,p P' tativcs of a deceased cmploycr, P y of the forcgoing•engagcd in a joint enterprise, and including tho legal rcprescn c to ccs' Howcvcr the arinershi association or other Jcgal entity, employing mp Y receiver or trustco of an indiyidua, P P, owner of a dWelling h0use haying not more than thrcc apartments and who resides thcrci r or k occupant c in other who c loys persons to do maintenance,construction or repair work ed to beon such dan employer." dwelling house of an m or on the grounds or bv�ldrvg aPP'-tenant thereto shall not bocaue of such employment be eem MGL cha to 152, §25C(� also states that"every state or local licensing agency shall 7Rithhold the issuance or Pto regewal of a license or permit to operate a business or cc of coin sli ace vsithd the sxnSuran� °er gcrequired." applica.nt�who has not produced-acceptable en P ;. . Additionally,MGL ohaptor 152, §25C(7) states 'Neither the°�Qonwci&hvidcnce of compJienee with�the insurance enter•into any contract for,the perform2nee of public work until P tablc requirezaents of this cbapter have bccn presented to the contracting authority. 4 Applicants. Please fill out tho workers' compensation affidavit completely,by chccbg the boxes that apply to your situation a-nd, ncccss , supply sub-contractors)namc(s), address(cs) and pbonc numbcz(s) along n c�oyce(s)of than tho azYwith insurance, Limited Liability C°'mpamcs•(LLC) or Limited Liability pa�crsblPs (L wombcrs of partnors, arc not xcquircd to cat a oz�ksc of fidoamvP tin ubias�mitt d to the Dcputm n of Industrial employees, a policy is required Bc adyiscd Accidents for confiunation of insurance coverage. Also be sure to sign and datetheucf��R t thr,pep�cntOf bo zeturncd to the city or town that the application for.the permit or I1eould ou arc rq cd to obtain a workers' Tndvstrial Accidents. Should you have any questions regarding the law or if y compensation policy,please fall the pepaxtment at the number listed below. ScLf-insured companies shou]d enter thcis self insuran�o license number on the appropriate lino. Clty or TowP Qfl3cinls it tho Please be sure that tho affidavit is'con-iplctc and printed legibly. The Department has Pro i re aiding the. �� of the affidavit for you to fill out in the event the Office,which will be usccd as ah frcnccccnumbcr. In addition, an applicant Pleaso be Sul•e to fill in the perm'vUccnse number von car aced only submit onp af5dayit indicating currcztt that must submit multiple permit/liccnse applications in any gi Y , polidy information(if peccssary) and under"Job Site Address" rho applicant should write"all locatr town may ti ns j nd� (to there or town)."A cbpy of the sfl davit that has bccn bfficiallystampendm ts omark�dmb s A now the city oaffidavi mustbo FM out each appli ,uA as proof that a valid affidavit is on file for fir p year.'V>'hero a homo,owmer or citizen is obtaining a liccnsc or ppzmit not related fo any business or commercial vcntuze (ie, a dog license orpermit to bum leaves etc.) said persoA is NOT required to complete this affidavit Tb Offacc of Investigations would liter to thank you in advance for your cooperation and should you bays any questions, please do not hcsitatn fi give us a ca1L Tbo Department's address, tcicphonc•and fax nuzobcr: Frock Tha Commonwc- th-Gff A nhli�i:M D'PUtmtiAt of Iudus�4 AC,Cidc;Ilts Offlce of Iuyv ,Stigatiaus 4 . 600 Washington Street BQS`ton, MA 02111 T�L #'617-727-490.0 ext a-06 Pr 1-8.77-MASSAFE Fax# 617-727-7749 Revised 11-22-06 ww-.ma.5s-goy/dia s F THE r own of BG`�.�ns�a� le °k-�� Re ulator -Services B_kRNST,03LE, Thomas F,-Geiler, Director hose 16:59. �`m niIding.Division ` �'pr�oµat -. $ � • Tom Perry, Ruilding Comm4ssioner . 200 Main street,, Hyannis, MA 02601 z a wNvw.town.barnstabie.ms.us Office: 508-862-4038 Fax: 508-790-62: Pro�).erty ®wnet Must Cbliiplete .and Sigil This 'S ect on. if Us11 gA`Bbildel t�15 �p4MC'.L 1$ . , 1(t��as Ow der of the subject propetty ' hereby autbotlze to acf on'my behalf,; is in all matters relative to work authotizedby this building permit applicatio for: (A te5s of jOb�: V -Sigriature of Owner Date ' -== µ Print Nance • If Property Owner is applying for permit please Complefe tT�e Homeotiers T� cense Exemption POrn7i on the reverse side. anastable Town of � . of'HEr Regulatory Seryices Thomas F. Geiler, Director t B,lgptyTAB[�, MASS Building Division i67P, PTEo M'tA Tom Perry,Building Commissioner . 200 Main Street, 'Hyannis, MA 02601 Rrlyly.town..b2rustnble.m2.us Fax: 508-790-6230• office: 508-862-4038 ---__— T30AZEOWNER LICENSE EXEh'IPTION plcnse print DATE: JOB'LOCATION: street Yillage number "HOMEOWNER": home phcnc N work phone# name CURRETIT MAILLNO ADDRESS: zip code city/town slate ied of ts or Icz.s and The current exemption for"homeowners"was extended o include does ot posses a livens, olnded that tha owner acts as to allow homeowners to engage an individual for hire who d p sul:)exyisor. DEFMITION OF RoMEOli'NER 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 such use d/or farm structftf be, a one or two-family dwel)ing, attached or detached struciuredssaccessory11 not beoconsidezedaa homeownerr.. Suchs, A person who constructs more than one home in a t�vo-year peso 'hOrne°Wner"shall submit-to the Building Official on.a formc�tpt ctionble to 1109 1 )Building Official, that he/she shall be res onsible-for all such work performed under the buildin (Se liance with the State Building Code and other The undersigned "homeowner" assumes responsibility for comp applicable codes, bylaws, rules.and regulations, rp ble in Th"a undersigned "homeowner" certifies that he/she understands the Town ° Bvnttl said procedures and minimum inspection procedures and requirements and that he/sh y requirements. Signature of Homeowner Approval of Building Official on 0o00 l. cubic feet or larger will be required 10 comply with the Note; Three-family dwellings containing 35, State Building Code Section 127.0 Constru HOMEOWNER'S EXEMPTION The Codc slate that: "Any homco"r-rperforming work for which a building permit is required shall be exempt from the provisions of this section(Section 109,1,1 Lieens�ng of construction SuperYisors);provided thal if the homeowner engages a person(s)for-hire to do such work, thal such Homeowner shall act as supervisor," the cndix)a, Many homeowners who userlY shhi`scCx S�lOsorsr Section 2.15)ty are as su This lack of away nesooftcnlreisvltsf in serious sproblppendiz Q, Rulcs &'Rcgu)ations forLiccnsing Con P when the homeowner hires unlicensed persons. In This east,our Board cannot proceed against the unlicensed person as it would Kith i licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To cnsurc that the homeowner is f tj)nds the rcothis/onshrT rccs ofsi iliL SuPcs',or.many 0n the la 1Upagc oftthis issue is alform rrcn)yluscd by that the homeowner ccrtif)that hdshe un - rr,r„✓rcn;rication for use in your community. 07/19/2010 07:32 5087782792 BOTTOMLINE BOOKKEEP PAGE 01/02 ovHroi -. SCOTT H . QI.JILT FR - BUILDING & [Zl�MO .C) EJ TNCr ` ` ti3 ,1' ' FAX . (svr) 710 kz.30 247 STRAWBERRY HILL RD. , r CENTERVII.Lli MA 02632 (508)771-0241 F.' k MA UC:11 CSOM010 07/19/2010 07:32 5087782792 BOT,TOMLINE BOOKKEEP PAGE 02/02 Aft�l r - 7 C q �B mil/ -' p- eg--- Ag �%✓ t,� yy _�Qe.4Xq i w 'tea z r �•4 ;r , i .vr.'' C M� Y: ,M1 Fy, rM f^ A r' S i �rjO' \.u'A !�!•!:. •,d,yh`'"K 1�n � rt. y�•J� ,4 r r I r^ �/ ,.rA. ." u�h M .0 p� lel' r 1' C r( ✓ •( 1 Mf ��lV' n T. � _ r -�—^F- .. y �N � � t M �� 4 f �. L` �� S �. .�{ �� i AC # 25 t��r: 1.33 AC .r:r°' -' STANDARD LEGEND + NOTE:not oil symbols will appear on a map f �° r GOLF COURSE FAIRWAY JOHNSON, ROBERT, KATHLEEN MA H AS, STE P E N T` MU R I E L cY�vv' EDGE OF DECIDUOUS TREES - MAP 248 EDGE OF BRUSH 2Jg ORCHARD OR NURSERY # 307 # 304 \ V EDGE OF CONIFEROUS TREES - - .35 AC -25-AC"___- -,- MARSH AREA - - EDGE OF WATER AIEL KRYS--TYNAA = _ _ — DIRT ROAD H EL-ECHOWSKI- MORRILIMAP 247 3 MAP 248 E DRIVEWAY �—PARKING LOT \ r 222 I��---PAVED ROAD \ \ ` �> r L tt # 9 — — DRAINAGE DITCH t z # �9pY *' 25 AC r' - - - - PATH TRAIL a \ \ k PARCEL LINE MAP# 21 --.—PARCEL NUMBER \ -- IB60 HOUSE NUMBER j� , COLOVS DE NIS SR & PAMELA 1 - - 2 FOOT CONTOUR LINE c \ MAP 247 \ 90 10 FOOT CONTOUR LINE 2 17 \ Elevation based on NGVD29 # 285 4.9 SPOT ELEVATION F I 30 AC y;` a� STONE WALL r y i* -X—X-- FENCE • RETAINING WALL e- \ �y ' ' i / �`-•� ,,1 m r� � -l-f-I-I-- RAILROAD TRACK STONE JETTY -' SUHIE, ANDREW T & DORIS :__ -. - " O�P DORIS C�°`=' SWIMMING POOL ' MAP 247 MAP 24� _ �� PORCH/DECK 218 It ' ^frraKr' � BUILDING/STRUCTURE # 275 103, p . - • '.j YT, # 2U6 -iu.-B-a . DOCK/PIER 31 AC �_ .36 AC O C? HYDRANT BURNETT, JOHN 6 OO S VALVE MANHOLE - - - - MAP 247 ----- / O POST Orr FLAGPOLE T O W 'N O F B A R N 5 T A B LL—E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N 1 T .a SIGN ® STORM DRAIN N PRINTED SCALE:IN FEET *NOTE:This mop is on enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 199S aerial photographs by The lames j`' m I"=100'scale ma and may NOT meet of property boundaries.The ate not true locations,and W.Sewall Company.To o ra h and ve elation were inter retell bom 1909 aerial halo ra hs h GEOD .UTILITY POLE p TOWER w.aSE P Y P P N Y P R P9 PY 9 P P 9 P Y `fir'Q 0 30 60 National Map Accuracy Standards of this do not represent actual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mapped to meet Notional Map Accuracy Standards s I INCH=60 FEET* enlarged scale. on the mop. at a scale of 1"=100'. Parcel lines were digitized from 2000 Town of Barnstable Assessor's tax maps. 4 LIGHT POLE O ELECTRIC BOX MaSsachusetts - Deportment of Public Safct} p Board of Building Rc�ulations and Standards constructio'n'Supervisor License License: Cs 78000 i f Restricted to cted to 00 � k� SCOTT H'' OUILTER a PO BOX 727 ~' �� r Y M 26 W H ANNISRORT, A 0 72 _ ,. Expiration: 2/3/2012 Tr#: 21477 Y ` # ir, rie �r�mmoiuiea a ✓ stcc�uael .IP- - . ? #�O�bi�CfrRJrEi<1CNTC:�ilf+ rrTOn O - 'a'7 SziF qt f 1 'i £F 1 � par a 3 � Tp°a Incft is n t 4i 1 i ��t j � - - iVl—as sachusetts - Deportment of Public SafetN Board of Building Regulations and Standards Construction. Supervisor License License: cs 78000 ' Restricted'to: 00 C e: SCOTT H QUILTER I PO BOX 727 W HYANNISPORT, MA 02672 Expiration: 2/3/2012 C' is onm•:sionerr7, •�- Tr#: 21477 m �,,� -� ��w b- t?►t�" r!r for r .� u.�.;,� �� ' , �,,� � Pbr"'l� � t��e+�` O t c?i�C�t�ttt z �" •-.. Y III p, r • _ ��"J"7 � r} a .,rN r�t",'Icl� (y�`�f3^..`�§' i�a "��� -a r� �'� f .. ' - _, �,�ii�1,``�. �a.w°t•` °•���:'',��' z �`!(�xEj cr a.:12l1�.. a' z a s i • Co` V n 27 wrle '; ,&iti 1 i I S JtT A 74-7 -. c7 �- ,_.. ... .•_ _.___.mow �' __._. ., — _�� , > --� �- 7,i y ' � 1 , � L d •`` $ i \ S �8te,'\� 3 � �V _ t a t i r a { t e t , Coil RL YI 7t �"lilt (7y_ 1i�j•c:' r �— �y t—^S 3 t� +c c r�e q Pi r KO c Vt.. Y u; Ott}r • i� ,1 Ai .,� T ti F.Y 'r 4—T rMG: A,T�vy C, u "� '2t1 ;x.� fir, r,a r ►.� t3�" t_4, J S 0 r- kj •{„� 1�>'7- ���t�l�►:� Cesar ,�� :..�• � ��' _ - W ! ... � y17 _ a( The Town of Barnstable Permit Massachusetts ' Date " 9 j �e 9 SOLID FUEL STOVE PERMIT Fee kj ,od This constitutes an official stove permit after inspection and approval by the building inspector. Pn a/4 � - Owner r Telephone no. Address of Property rill,ge 6171— Location and Stove Type_ K i c — 11R M o i ti S1Wt(-C-,0 �r5�( �CiY`1rL Lc S — �D P i+A-1 S?I W Date: ]Building Inspector The solid fuel burning stove at the above location passed: failed: inspection. Assessor's Office st floor) Map Lot Permit# 00 Conservation Office(4th floor) Date Issued 6 - Z9 — ?15, y Board of Health(31d f W)(8:30-9:30/1:00-2:00)7�/ Fee d O • O® Engineering Dept. (3rd floor) Hous / �---- - SEPTI CM SE Planning Dept.(1st floor/School Admin. Bldg.) INSTA P�.ANCE Definitive Plan Ap Planning Board 19 ENVI ® 5- �� TOWN OF-BARNSTABLE TO���9 �`�I ULATI�9N x Building Permit Application Project Street 37YI�iBein_y Lv� t Village CJ21,� •RAAL_pLE_ Owner Address _ 5 iM�,� 4 r Telephone Permit Request %U I LN O( Il- Total 1 Story Area(include 1 story garages decks square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ k17D Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization - Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family ✓ Two Family Multi-Family Age of Existing Structure �Q YAS Basement Type: Finished Historic House Unfinished Old King's Highway } Number of Baths ®06- No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Go,S Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number Address License# 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 CONSTRUC`Fr DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE _LL= 0DATE 2-F- BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR.OFFICIAL USE ONLY PERMIT NO. #8001 1995 June -29, DATE ISSUED - MAP/PARCEL NO. 247.2174 ADDRESS 285 Strawberry Hill Road. VILLAGE W.Hyannisport, MA 02601 ' OWNER State Street Bank & Trust DATE OF INSPECTION: , FOUNDATION FRAME 1 INSULATION FIREPLACE• ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH, FINAL FINAL BUILDING �-8 DATE"CLOSED O:UT ASSOCIATION 1'LA1 N0 11%02'94 17:02 V617 7 27 7 122 _ DEFT IND ACCID �0 r l.,oifunonwealilt of �%JJaclzusetb ' ..U�arfinen�o�-�,sduatria[./�'cctdsnts 600 Vl/aJU41,01t. hwii;f James J.Campbell &Ion, ii/aaaac�rwA 02f f f Commissioners Workers' Compensation Insurance Affidavit (4otmsealpesmaret) with a principal place of business at: (ctyist"Jzla) i ' do hereby certify under the pains and penalties of perjury, that: () I am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company Policy Number () l am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number (4,,4am a homeowner performing ail the work myself. I unders[ard that a copy of this itmement will be fo:v zrded to the Office of investigations of the DIA for c(n erage verification and that failure to sect:: cove-age:s rec_nr ed under Section 25A of MGL 152 can lead to the Imposition of criminal penalties consisane of a fine of up to s 1,5o0.00 andfor c year s• i .r-.,enc:u well as civil penalties in the form.of a STOP WORK ORDER and a fine of$100.00 a day against me. Sig ed th s day of ��✓� t 9 9 �� Lice ee/Permittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE :-( tt .t�� fig, JOB LOCATION j 97-r2 Ilk)&,-aR C E Number Street address Section of town "HOMEOWNER" C-�j Aj Name Home phone Work phone PRESENT MAILING ADDRESS SAh(E 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 such homeowners to engage an in-dividual for hire who does not possess a license, .provided that the owner acts as supervisor. DEFINITION OF HOMEOWNERS Persons) who owns a parcel of land on which he/she resides or intends to re-side, on which there is, or is intended to be, a one to six family dwelling,attached or detached structures accessory to such use and/or farm structures.' A person who constructs more than one home in a two-year period shall not be considered 'a homeowner. Such "homeowner"- shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes '.responsibility 'for compliance'with the Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Departm n jha mum inspection procedures and requirements and that he/she will comply i id oce es and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING 'OFFICIAL Note.: Three family -dwellings' 35, 000 cubic feet _ l be re to comply with State Building Code Section 127.0,�Construction r larger, 1Controlquired s. e. . HOME OWNER'S EXEMPTION The code state that: "An Home Owner `1'�. y 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 Home Owner engages a person(s) for hire to do such work, that such Home Ownex shall act as supervisor. " F Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This lack of iwarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed. Supervisor. The Home "Owner�'actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully awarelof his/her. responsibilities,. man communities require, as part of the permit application, that the Home -Owner 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. s . . : The Town of Barnstable • s�wvsr�. peg Department of Health Safety and Environmental Services 116 Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 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 strictures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work:. UC'Z Est.Cost Address of Work: Si C /1y (LL t20 Owner.Name: �C—AJ,13 t.S �..o f Date of Permit Application: I hereby certifv that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000 Building not owner-occupied c/ 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 hcrcby apply for a permit as the agent of the owner: Date Contractor name Registration No. OR Date Owner's name 17—94 THU 14 !OT 6N1_Lhxv Kmmw a i ,.I,,mr ;+�... a►�T � Ll fa , Ccx. i3� ' 'f�r�l�l �� � ^` � - , �' ' �� rig. •rr�n� �_ f �i ;,, t�l, �+ - r llt--== �y I•--� ; �y 1C.� IC, L,�'•Jq G'yIov t �y ►' IJ u<"!ti4_E' �I r , 1L , • •� f ,a 1.�v 12 9,4 3C, sr vt r� s 10 3 1� L. E'G ► L fJ Net t U OF �� •`� Ito 1�`T G' Et7 L A.t...� 0 ....:. ..:.z..y7 , � 7 Assefsors reap and lot number ..... SEPTIC SYSTEM MUST BE. wa INSTALLED IN COMPLIANCE tz `� - �'— WITH ARTICLE II STATE E Sewage Vermit number `• SANITARY CODE AND TOWN , f EGULATi0NS 'IN e roe, <~ _ ®F � R TOWN ' nT Z EJ$B;9TODLE y 9, MABL 1311.1 ]DING INSPECTOR �p r639•��0� �, o NAY ALICATION�FOR PERMIT-TO ....PP .......... .../2.................................................................................................. TYPE OF CONSTRUCTION- + >p .. ...r .G.... .19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......... ........................ ..............,..........��°: �x `.Y........................................................................... ProposedUse ...... . ........ .............. ....................... ..........................................:................................................................... Zoning District ..............................:...........:.....:.......................Fire District ...1!!";.A...............................................' Name of Owner � 'Q-�. Address /2 3 �' / ........................ . .f.�. ............... .. ............. ........ .?.f..................... Nameof Builder ..............................:.....................................Address .................................................................................... Nameof Architect ............................ ....................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ....... .............................�-� �............................. Exlerior ...... ..'..��.1....j....C&f.......................................Roofing ................... ............:... Floors Interior .............. . VL Heating Plumbing ............... ....,.C""f"'� ""P�..t'............... _ at g ............... (�....`�/. Fireplace .................. ............................:......:.......Approximdte Cost .,/.:�. ? ......... ........ 6z "� Definitive Plan Approved by Planning Board _______ .___ _________19_ � Area '.... ................. Diagram of Lot and Building with Dimensions Fee .......... ..�.......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 2y . z� / `( 2 `( 2 `� (fir 2 ' S� 2 � � hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. _ >�{ry ! �� • Name .f.�c!KX:..1'r�f. :.. ....... . . . / . . . ^ - ^ . � � . / - - - . ' ' Danielle Trust single family dwelling Centerville [�vvner ----.�ao���.�e..�roa�_. _.. .. . �� �� —� ---' . — --� , ' ^ . � . . . Typo of Construction .......frame---.�---_ ----.-------.~-----'��------ . ` . ^ , - #1 Plot _---, ......... Lot .......... .................... . um% 126 - 76 Permit Granted ........ ....-------.lg ' Date.of h --- ' ---.lQ ' .. ! � ' Dote Completed '�.����/��� ----l� . . . ` . ~ . ' . "^RM=" REFUSED� . ' .----'—.,.--.------._--.. lA ^ --------'--~--------------- ' . . --.—~--...—.---�.--.---------. , ` ............................................... ' `. . ' ----. �---.--..------.—...----... -� ^ � ` - Approved ............................................. lA ^ -------'------~~^------~^--'' ` . . ................. ` ` . ��� Assessor's map and lot number �v 7 Sewage Permit number .......................................................... P%,0,FTNETQ�♦ TOWN OF BAR NSTABLE �v O� I HAWSTAXLE. i " 9 a war a' BUILDING INSPECTOR � . APPLICATION FOR PERMIT TO ...7y�.� .............................................................................................................................. TYPE OF CONSTRUCTION ............... _................. .................................................. !:. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................................... .........................................................:.;::.:..........................................,.........................,............... Proposed Use Zoning District ........................................................................Fire District ...La Name of Owner ....`...............r�............../ ^-.......................Address ....�............... ��... ......./ Nameof Builder ....................................................................Address ................:................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ......U..................................................................... Exterior .... 1....,.... ... .......................................Roofing ................... .................................................... Floors a^^"`�� Interior ...... ........................................................ ...................... ............................ Heating ... .. ..... .............................................Plumbing ............... Y................................ _ , .............................. Fireplace .................. ............................................Approximate Cost .. .. .Z�. .......... :................. Definitive Plan Approved by Planning Board _____ i Y �...... ....N ----- _'7�? .» •-=�.. .�. . .................• i -------19 Area �- ..�- Diagram of Lot and Building with Dimensions Fee ........../'F................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH `c 2 (� / L( t� 62 � � y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Danielle Trust &=l-47-17—' . ~ . . 18618 l l/2 'No Permit for '—s single family &ielling -------------------.--.^�.--- ,~�tcav�berry Hill Road ....... ���—"------.------------- Center 1 . -----------D'a�i1 l Owner ------ frame Type of `'. . . . ' ^ � \ . _ ....................... -~. / \ ' Permit. ~....^~ '. . ' `- � . . . . uo/e on Inspection . . \ < Dote Completed \ . ' . | ' � PERMIT \ -------.--./i---------.. 19 � � . . < '---- `------- ' � '----'' 'f7 �«.~��— ' ��--------' \ � . � � ' ...—..--------------...-----.. > ' � .------.--..----...--.--.-.---... � . � ' Approved _--------....�.�---.. lA / ^ . -------'--------�i'';--`-----''- . > ' � ! . ----_____________,,_,,_._,,,_ -� _