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'. . .... . .....,. ,....„. ..,_ „ ..,„ „.,-,'..,,.....,.. '.' ' •- ., . . ... . ,. . ; ,....- ...,,.. ,,,_... . 2,_.„.„. , r 0t Application number.. { V� O" er eIiS Date Issued‘1,659' r ' y Buddin::1e 't pectorsnials 4��y SE 1.9 1 TOWNWP RS'TABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO W S/DOORS/TENTS/S'I'OVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: e?7 g(® rnaZrt. S L/# $air S'10.0 NUMBER STREET VILLAGE Owner's Name: R I c.(tea,..d + (eh e S Li crwa n Phone Number Sri-77(,— .0$(e% Email Address: Cell Phone Number 0 Project cost $ 20,000 ' Check one Residential ✓ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK El Siding El Windows (no header change)# ❑ Insulation/Weatherization ❑ Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to e L :`d S J 1)04.,n 3 CONTRACTOR'S INFORMATION Contractor's name v,kqi A rSenaotr Home Improvement Contractors Registration(if applicable) # I H a3 (attach copy) Construction Supervisor's License# pA l 361-7 (attach copy) Email of Contractor Phone number SDI-39 - 47 t{ ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER ,...,... 1 *For Tents Only* Date'Tent(s) will-be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X , X , X Additional tent dimensions can be attached on a separate piece of paper. Check one: this,event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tel If food is being served at your event please obtain a Health Department approval between the howls of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES * Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side _ HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number - Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 7E:0 CMR and the Town of Barnstable. Signature Date _ APPLICANT'S SIGNATURE Signature cL �,, ,,�,� Date 9/i q)dOj g_ All permit applications are subject to a building official's approval prior to issuance. r � The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations = ff 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): tgc1 A senq,(7 Address: So P Qct,Scuvc a-& City/State/Zip: t)e5c- AAA..te YYy} Phone#: gbg Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I /employees(full and/or part-time).r� * have hired the sub-contractors 6. El New construction 2.I oT i am a sole proprietor or partner- listed on the attached sheet. 7. 0 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 11.0 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. 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.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under he pains and penalties of per' ry that the information provided above is true and correct./ Signature: e ( bt.d Date: 9 !l q!DO / Phone#: SOg' 3c18— 4-1-7113 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 p4 Massachus General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to 's statute,an employee is defined as"...every person in the service of another under any contract of hire, express or imp • d,oral or written." An employer is de ed as"an individual,partnership,association,corporation other legal entity,or any two or more of the foregoing eng ed in a joint enterprise,and including the legal represen,=fives of a deceased employer,or the receiver or trustee of individual,partnership,association or other legal en ,employing employees. However the owner of a dwelling ho having not more than three apartments and who r-sides therein,or the occupant of the dwelling house of another employs persons to do maintenance,cons ction or repair work on such dwelling house or on the grounds or building ppurtenant thereto shall not because of suc employment be deemed to be an employer." ` MGL chapter 152, §25C(6)also ` •tes that"every state or local licens'il g agency shall withhold the issuance or renewal of a license or permit to f 'erate a business or to construe buildings in the commonwealth for any applicant who has not produced acceptable evidence of complia 1 e with the insurance coverage required." Additionally,MGL chapter 152, §25C'')states"Neither the comm,nwealth nor any of its political subdivisions shall enter into any contract for the performan,e of public work until ac eptable evidence of compliance with the insurance requirements of this chapter have been pre ented to the contrac•.g authority." Applicants Please fill out the workers' compensation affda it complete ,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),addr s(es)an' phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or . ited iability Partnerships(LLP)with no employees other than the members or partners,are not required to carry worke c., pensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this a'fi.•vit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Als t be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for :e .ermit or license is being requested,not the Department of Industrial Accidents. Should you have any questions '-g • g the law or if you are required to obtain a workers' compensation policy,please call the Department at num er listed below. Self-insured companies should enter their self-insurance license number on the appropriate lin;. City or Town Officials Please be sure that the affidavit is complete and p ted legibly. ' e Department has provided a space at the bottom of the affidavit for you to fill out in the event the,a ffice of Investig:tions has to contact you regarding the applicant. Please be sure to fill in the permit/license numb. which will be use. as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given ye.., need only submit one affidavit indicating current policy information(if necessary)and under"J.. Site Address"the app"'cant should write"all locations in (city or town)."A copy of the affidavit that has been r fficially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on le for future permits or licen es. A new affidavit must be filled out each year.Where a home owner or citizen is ob ing a license or permit not rel ed to any business or commercial venture (i.e.a dog license or permit to burn leaves c.)said person is NOT required t. complete this affidavit. The Office of Investigations would like to hank you in advance for your coopera. on and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone an' fax number: . e Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street L..... Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MAASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.govfdia r Proposal Page No. of Pages wo,Icy wiz. -Tv . ' dOp.� bl PCP. • Lic. #091397 A RSENAULT Since 1990 • Reg. #146239 Roofing & Siding References a,d • Insured 30 Pleasant Road • West Harwich,MA 02671 Lnsw-ante Certificates •Certified 508.398.4743 ftvailalale upon Request PROPOSAL SUBMITTED TO JOB NAME STREET JOB LOCATION a7 VC) hnCk n 5.1". 2r. (,,A CITY,STATE and ZIP CODE Ctv-n S 1ZXUki, mk. PHONE < 7(0 on? JOB PHONE 5'0$- DATE / ' S 30z.. tom_ H g/3a/tc We hereby submit specifications and estimates fork: ^R crQ v p n u O liS� a chi ,� �'S cl r R y ( t\D 64r r1\j • Strip all existing roofing and remove debris. 6.\„tr. Waoo) • Inspect roof deck for loose boarding and renail as needed. • Install all new aluminum drip edge, pipe flanges, and counter flashing. (u t i.-r' Aep cdy) • Apply a water and ice shield underlayment around all chimneys, pipes, skylights, in valley areas, and along bottom edge of roof. • Install a t5fb-Aoft paper underlayment on all exposed roof deck.( i-VIA - Qycer) • Reroof with a specified roofing material. (see options) • Six galvanized nails per shingle are_used for high wind protection. • Chimney flashing will be sealed with a clear silicone sealant. • All gutters, siding, landscaping, etc. will be protected during construction and left spotless upon completion. kcOootz.► Pirlaz-erktk% = Shingle Options: 1 C„Q!`..rginrtcd L0.nC•'trnart� -Pr0 `F' ao r7i40. C`v ,..„2,14 Tn�Ic�alzS: �itc�4'�. J�nr `ReQtgce. z uf�Pe1' 540cft- — Ne".1- t nor ,: i TOO ( -00e5 r c r =rncLx e ,Ne.u. r ocTr tOO(J'CkS co.riOen'ryy i-cec,1 s, .KJTdn4fi e vrr, 1'c,c)C y ige Propose herebyrep to furnish material and labor—commplete in accordance with above specifications, for the sum of: 00 T—w�,�.� t r�0 i-►-�U.�Sc1lrj M... h " ��1 C� dollars($ Z.2`.i e'1 C� ) Payment to be made as follows: One half in advance and one half upon completion . Deposit Paid: `r�� n, a /6 �� (PLEASE MAKE CHECKS PAYABLE TO: GREGG ARSENAULT) All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders,and will become an extra Signature_ L_}fr/Aii, 6.4,4C4,Zetti#) charge over and above the estimate. All agreements contingent upon strikes, accidents 30or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. Note:This proposal may be Our workers are fully covered by Workman's Compensation Insurance. / withdrawn by us it not accepted within days/ Arre tonre of proposal—The above prices,specifications z P ' .i 'J g '� and conditions are satisfactory and are hereby accepted. You are authorized Signature% to do the work as specified. Payment will be made as outlined above. .�✓ \ Date of Acceptance: Signature \ j • • • • • I • -.0°72e Volmnanttiea/th aladoczcAttoel6 CN. Office of Consumer Affairs&Business Regulation fife HOM72774x.,:liEnNdiTvidCuOaiNTRACTOR Registration E)_(patIofl • 04/06/2019 • GREGG ARSEN'04.7C VfIV.V GREGG W.AR$EN4W -T-• 30 PLEASANT RD I WEST HARWICH,MA 02671 Undersecretary • - •---• • • tFt Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-091397 Construction Supervisor GREGG ARSENAULT of 441 4,4 ' 30 PLEASANT ROAD . J, • WEST HARWICH MA 0267,1 •• -rwk: 414 , /4e,a..., Expiration: iCommissio er 01/26/2019 a, •e.00 Verizon cSi 9:-30 MI r] c ;;` Q The Schifty Whale OM . ti",firr a • 4 x , U .ie:- Tip,., 4 `, , Loca6 Pub and hang out, known for • .goo wrinks, fun parties, and great at... -.", The Schifty --re:4i/. • t • Whale -4 • Message ,.'t — -1-1 G sd • ie, Ca k i n ico Lille Follow Recommen Sa {e s �, 8a • Barnstable. Mass ach_ � us .. • Home About Photos Reviews Posl _ 15 0 e dui, Els i emu. • j19 ( Mein at. _ �. in +k bo,, ,t, .. . • • about:blank Page 1 of 1 at Page 1 of 1 I i • i 6 • • , -, 3!. --:- `.a a s • .was r 4 En _ + - a t+ _ i £"r� f1 u. ! i r+ r}� ���.t ,j mot, (yI ++R g _ ri A �a t 1./2`•�'/ t Y. rP "'! T4UP ej! �} `rcli iro- 6 ��r = x f - `.fit'y,., ,; - ...,yam,_`'. . #' - >. t r.. 60. .."-' ^'? ?^�'!_.. -r",_ „,, alr...t t11 • " a'} T •• y ` f http://townofbarnstable.us/propertyimages/00/12/51/62.jpg 8/16/2017 Official Website of The Town of Barnstable - Property Lookup Page 1 of 4 Select Language I♦1 1 Assessing Division Property Lookup Results - 2017 C .1. 3.67 Main Street,Hyannis,MA.02601 -• <<BACK TO SEARCH« £ Print Friendly - Owner Information-Map/Block/Lot:258/027/-Use Code: 1010 f ` Owner Owner Name as of SCHIFFMANN,SR RICHARD F& Map/Block/Lot GIS MAPS 1/.1/15 JEAN E TRS 258/027/ 2786 MAIN STREET Property Address 2786 MAIN ST./RTE 6A(BARN.) -' BARNSTABLE,MA.02630 Co-Owner Name SCHIFFMANN FAMILY TRUST Village:Bamstable t Town Sewer At Address:No GIS Zoning Value:SPLIT RF-1;RF-2 ' Assessed Values 2017-Map/Block/Lot:258/027/-Use Code:1010 2017 Appraised Value 2017 Assessed ValuePast Comparisons Building $215,200 $215,200 Year Assessed Value Value: Extra $15,700 $15,700 2016-$554,900 Features: 2015-$582,500 r 2014-$582,800 . 2013-$583,200 Outbuildings:$7,200 $7,200 2012-$596,100 2011-$664,400 j- Land Value: $316,400 $316,400 2010-$672,000 . 2009-$753,100 2017 Totals $554,500 $554,500 2008-$795,900 2007-$830,500 Residential Exemption Received=$90,532 Tax Information 2017-Map/Block/Lot:258/027/-Use Code:1010 I Taxes Barnstable FD Tax(Residential) $1,641.32 Community Preservation Act Tax $132.79 Fiscal Year 2017 TAX RATES HERE Town Tax(Residential) $4,426.25 $6,200.36 Sales History-Map/Block/Lot:258/027/-Use Code:1010 I History: http //www.townofbarnstable.us/Assessing/propertydisplayscreen17.asp?ap... 8/16/2017 Official Website of The Town of Barnstable - Property Lookup Page 2 of 4 Owner: Sale Date Book/Page: Sale Price: SCHIFFMANN,SR RICHARD F&JEAN E TRS2013-03-15 27210/261 $1 SCHIFFMANN,SR RICHARD F&JEAN E 2013-02-05 27105/97 $1 SCHIFFMANN,SR RICHARD F&JEAN E TRS2003-03-17 16582/145 $0 SCHIFFMANN,RICHARD F&JEAN E 1979-12-10 3028/20 $0 Photos 258/027/-Use Code:1010 New � dory: Sketches-Map/Block/Lot:258/027/-Use Code:1010 • ,fiQa F i, • As Built Cards:Click card#to view:Card#1 Constructions Details-Map/Block/Lot:258/027/-Use Code:1010 Building Details Land Building value $215,200 Bedrooms 4 Bedrooms USE CODE 1010 Replacement Cost $358,652 Bathrooms 3 Full-1 Half Lot Size(Acres) 1.24 Model Residential Total Rooms 9 Rooms Appraised $316,400 Value Style Colonial Heat Fuel Gas Assessed $ Value 316,400 Grade Average. Heat Type Hot Water Plus Year Built 1846 AC Type None Effective 40 Interior Floors Pine/Soft depreciation Wood Stories Interior Walls Plastered Living Area sq/ft 3,722 Exterior Walls Wood Shingle Gross Area sq/ft 5,318 Roof Gable/Hip Structure Roof Cover Wood Shingle http;//www,townofbarnstable.us/Assessing/propertydisplayscreen 17.asp?ap... 8/16/2017 Official Website of The Town of Barnstable - Property Lookup Page 3 of 4 • Outbuildings&Extra Features-Map/Block/Lot:258/027/-Use Code:1010 Code Description Units/SQ ft Appraised Value Assessed Value FOP Open Porch-roof- 234 $5,700 $5,700 • ceiling ' r FPL2 Fireplace 1.5 3 $10,000 $10,000 r, stories BRN1 Barn-1 Story 660 $4,700 $4,700 WDCK Wood Decking 366 $2,500 $2,500 • w/railings Sketch Legend Property Sketch Legend B2N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished)FUS Second Story Living Area SPE Pool Enclosure (Finished) BRN Barn GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic • FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio Print Friendly Acting Director iPamela Taylor 508-862-4022 (F 508-862-4722 8:30a.m.to 4:30p.m. Public Records !Ann Quirk • 'Public Records Request P 508-862-4022 http://www.townofbarnstable.us/Assessing/propertydisplayscreen 17.asp?ap... 8/16/2017 Official Website of The Town of Barnstable - Property Lookup Page 4 of 4 ,367 Main Street :Hyannis,MA.02601 Helpful Links to Downloads I Abatements , SALES LISTINGS .- Barnstable FD t f i # Residential C.O.M.M FD Residential Commercial-Industrial- • Mixed Use Cotuit FD Residential Hyannis FD Residential Townwide Condominium � I W.Barnstable FD Residential Exemptions Parcel Consolidation Questions about values i x I FY17 Combined Tax Rates Town Land Use Codes Helpful Maps All Town Maps • Flood Insurance Maps Property Maps FY17 Tax Maps j J Owned and Operated by The Town of Barnstable-Information Technology Home I:Departments&Services I Boards&Committees I Residents&Visitors I Doing Business I Town Calendar I Phone Directory I Employment I Email Town Hall • • http://www.townofbarnstable.us/Assessing/propertydisplayscreen 17.asp?ap... 8/16/2017 n s PosFThis=Carisiih.a tLtvi ibals romT eow of vB,1„,ci,:r nVstab�l , -. .v.-ya,rTv ', 4.:3 -._.M r.. .;.uR " rx ',t.d Mus ?-e at p u 's , y;.x<w. sao7flu s b*;r.Rae.Taed on� ant , r I Build1nAi� A . : Y H _ ee Made: � h . k ' il,a ln eo t .; enma Posted-Until,Finatlnspectwn nWhe e , aertifcaterit ccuanc sRe i ed uch uildm t be"Occu Occupied na ,. , Perm' Permit No. B-17-785 Applicant Name: Craig Bishop Approvals Date Issued: 03/27/2017 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 09/27/2017 Foundation: Location: 2786 MAIN ST./RTE 6A(BARN.),BARNSTABLE Map/Lot: 258-027 Zoning District: SPLIT Sheathing: Owner on Record: SCHIFFMANN,SR RICHARD F&JEAN-E TRS '' ' a ' C�ontractoriN a Craig Bishop Framing: 1 Address: 2786 MAIN STREET , � ContractoriLicense CS-109777 2 .A ILL ( A BARNSTABLE,MA 02630. ' In `� " ._ fst PraJect Cost $3,122.00 Chimney: Description: Weatherization&Airealin 44 I � P g Ptrti1e: 85.00 ,Y $ Insulation: 1 Project Review Req: Weatherization&Air Sealing i fee aid. $85.00 t ; • Final: A. Date 3/27/2017 11 s g �` - ,f 0 Plumbing/Gas rtiA,,,11:17:',15!":Leitti. 2'''Ye.,,,,,,„_l''''Q'2,',2::,''',':/'7., 7'1";','r Rough Plumbing: Building. Official Final Plumbing: This permit shall be deemed abandoned and invalid" unless the work authonzed by this permit is commenced within sixtmonths after issuance ': Rough Gas: All work authorized by this permit shall conform to the approved application and'the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structurespshall be in compliance with the local zoning by laws-and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. r f .. , "rk Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Buuildmg anddFire'l9ffic%alsare provided on thispermit. Service: .Minimum of Five Call Inspections Required for All Construction Work r 0 y t * 1.Foundation or Footing Rough: 2.Sheathing Inspection 115 ,- `"' .. 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 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. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable ,REEaT BARNovaut 200 Main Street, Hyannis MA 02601 508-862-4038 s63q. � Application for Building Permit Application No: TB-17-785 Date Recieved: 3/22/2017 Job Location: 2786 MAIN ST./RTE 6A(BARN.),BARNSTABLE Permit For: Building-Insulation-Residential Contractor's Name: Craig Bishop State Lic. No: CS-109777 Address: , Sandwich, MA 02563 Applicant Phone: (774) 205-2001 (Home)Owner's Name: SCHIFFMANN,SR RICHARD F&JEAN E Phone: (508)362-8543 TRS (Home)Owner's Address: 2786 MAIN STREET, BARNSTABLE,MA 02630 Work Description: Weatherization&Air Sealing t.Dj cr) Total Value Of Work To Be Performed: $3,122.00 , Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Craig Bishop 3/22/2017 (774)205-2001 Applicant - Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $3,122.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 3/22/2017 $85.00 XXXX-XXXX-XXXX Credit Card 3464 Total Permit Fee Paid: $85.00 *411504 mow_ Town of Barnstable of . *P rmit 'd/ Ct07()) dF�l `'`'`' '`IT es oc% t froue date a3( `'� Regulatory Services e BARNSTABLE, 71111539. ., -2 2014 Richard V.Scali, Director "'rooms 6 t ' "t OF BARNSTABLE Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ' 625: /av?Property Address (9 7? /1)4//IJ S,Tee7 AKC1/44k [✓]Residential Value of Work$ /.(SO 0 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 49/C#4471, Contractor's Name Telephone Number , af'7a,2 Home Improvement Contractor License#(if applicable) Email: ,e/-7,c0// J=/t'l tj,U4/ ,yfic .Cd/1 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor Pre1 am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) 'Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) VRe-side Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows fed 2. #of doors: " ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: ZLL Q:\WPFILES\FORMS\building permit forms\EXPRESS.do Revised 061313 'town of Barnstable Regulatory Services �DUB/bye, Richard V.Scali, Director �f,. 9• Building Division s�uervsrAeu. • Tom Perry,Building Commissioner \i �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION _ �/ Please Print DATE: OC/' 0 c20/r A*-JOB LOCATION: 7/ "VA) S7-4 CPT t y� �4e/v574-3t to `" number �+ street � village "HOMEOWNER": OC//"V, 2vi Y/2- ay$ ' 3 name r� Q /y home phone# work phone# • CURRENT MAILING ADDRESS: G'2 /////V .. 4 FED' /� /5'/3/9/ 1 cr4gLtd' 4 Oa��a city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner, Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed , Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. 1 • fleV4ifk96 S BARNSTABIA %A 1639 Town of Barnstable mob Regulatory Services Richard Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section \ If Using A Builder I, ,a. et of the subject property hereby authorize o act on my behalf, in all matters relative to work authorized by thi building permit application for: (Address of Job) �---- Signature of Owner Date • Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPFILES\FORMS\building permit forms\smokecarbondetectors.doc, Revised 050412 3 A "E, Town of Barnstable *Permit# b Expires 6 mont from issue date THE °� Regulatory Services Fee • BARNSTABLE SS. , : Thomas F.Geiler,Director ArEa .�� Building Division Tom Perry, Building CBO, Commissione r 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address of 7`g to. M i411✓ [residential Value of Work y a-(50, Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address t C k A a: Sr k , M t 1.►•t MA I t t ,<4. ,Dig AN s-1,44/ Contractor's Name TbS G NA .J lid ►r1- Telephone Number )08 LI'5a as 7.2 Home Improvement Contractor License#(if applicable) I 5 I ER 1T - teP a a , ❑Workman's Compensation Insurance �L1� Check one: S E P ❑ I am a sole proprietor ❑ I am the Homeowner. TOWN OF BARNSTAB , ©'rhave Worker's Compensation Insurance Insurance Company Name t` (j e4-4 t( v1 04,A L. Workman's Comp.Policy# LIJC ( � t S "3 4 a 1 L O o Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) • �e-roof(stripping old shingles) All construction debris will be taken to }- EAC'>7 iVV ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.mil *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: ti Q:\WPFILES\FORM S\building permit forms\EXPRESS.doc Revise020108 re s4 'b. oe THE?c , Town of Barnstable 'j� ~., Regulatory Services te7 MASS. � Thomas F. Geiler,Director 4'p/ED pith Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, t.0 lR j L R f✓1 A m tom! , as Owner of the subject property hereby authorize osgk to act on my behalf, in all matters relative to work authorized by this building permit application for: d 2g6 MAirl Si . /aRtviihJ/e .A4/ (Address of Job) Si:111 . / :1,recr wner pfft ate V CI 2 /11 r Print NaA r` i D Cam' G /q If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. . Town of Barnstable P, T E Tp�� .,►i Regulatory ulator Services ggi , o g Y T. sAxxsrAtrte. Thomas F.Geller,Director .P MASS. q, 1639. %� Building Division �T`�° � Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-41 38 Fax: 508-790-6230 HOMEOWNER LICENSE E , PTION Please Print DATE: JOB LOCATION: nu .er street village "HOMEOWNER": name home p'one# work phone# CURRENT MAILING ADDRES : city/town state • zip code The current exemption for"home°,1 ers"was extendei to include owner-occupied dwellings of six units or less and to allow homeowners to engage an inc ividual for hire ho does not possess'a license,provided that the owner acts as supervisor. DEFINIT;•N OF HOMEOWNER Person(s)who owns a parcel of land on w`'ch he/s a resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached o deta ed structures accessory to such use and/or farm structures.A person who constructs more than one home in .,o-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Officil on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under ,e i•ilding permit. (Section 109.1.1) The undersigned"homeowner"assumes respo:' ibility ►., compliance with the State Building Code and other applicable codes,bylaws,rules and regulatio u:. • The undersigned"homeowner"certifies tha he/she understans,,. the Town of Barnstable Building Department minimum inspection procedures and requir rents and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official • Note: Three-family dwellin:s containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 S'snstruction Control. HOMEOWNER'S EXEMPTION • The Code states that: "Any homed er performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of,onstiuction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. DK� � pra�� 7-d�-e�� A5sessor's'office (1st floor): ^^ K,n• `7/, THEAssessor's map and lot numbe•r .....7- orricivi66s'wicht/r °' SA �vs ST B� /l� ; �Q�°� TO�oBoard of Health' (3rd floor): ....fJ.. � • ��4�p�";,�,,.�;�. 0;�� COM Lb CE Sewage Permit number r; t,. • tl Baaa9TSBLE, !�li�� _ „o T� LE J � MAZaEngineering Department (3rd floor): E��it ��1ENT�l'CODE � � ���\ Y �e� House number $6 aDefinitive Plan Approved by Plannin ' T�WN REGULATIONSAPPLICATIONS PROCESSED 8:30 9:30 1:00 2:00 P.M. only TOWN OFF BARNSTABLE BUILDING INSPECTOR • - APPLICATION FOR•PERMIT TO '9� �O 61'" L L //v TYPE OF CONSTRUCTION —C/N CL C 1 /'Tf4/ . / Yam' I L L/A" C l' . Sepr 7l 19.h I TC\ THE INSPECTOR OF BUILDINGS: The\ndersigned hereby applies for a permit according to the following information: Locati& ....‘2.!7.e6....f114./4) ST..R.t.Q.T 6Wd./fry9s4 e . DA C L6/A I( . . Proposed Use Zoning District A �a Fire' District /C�S-777Q(-4" Name of Owner I9/C///RO P 7-e4/1/ " ///.Ffflh1/i Address a78"G..RA/ ) ‘CT44'e r B/ N/474aer NIA k 'Name of Builder (5 kik)P Address 1 Name of Architect Address • Number of Rooms Foundation , Argzo avNc a 1 Exterior Q.Q.1 ff. 1.N... 'LS/ C. J LQ�� Roofing Woo D S /IU GL CS WO°Floors -12 Interior &1' 1t) 1.,L • • Heating -57 r/ N1 I Q /L Plumbing 'Dp Fireplace Ala NC A-d p f'Q Approximate Cost " �l ®o nn . Area •... DiC�o!•... .4.O.....7..(' ! , 5©Diagram of Lot and .Building with Dimensions • Fee � • • • • • OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS • I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above •construction. - Name .... . 1� Construction Supervisor's License ooil e f' ----- 4! 'SCHIFFMANN, RICHARD & JE?iN +. _ ii ` • `• 'No 3*2260 .Permit for ADD TO • ►• ,- Single"Family Dwelling ' a Location 2786 Main Street �.• - BarA$.tab�,e - . l', �'\ / ', t- Owner Richard & Jean Schiffmann- - l = `; ♦ • '• Type : :trttb0n .F. a. .e - i ' 1 • Plot Lot _ ; • Permit Granted September —1 3;19 S' r ▪ Date of Inspection 'J�,e o=` 1:9 t _ i▪ Dat, Completed • 72... '19 .; r fff . '.w �...1" Y 1 '..- ' , •I fit' f e �. — s C 3 0r - ! `• . - .. J .` . ' r r • R Y T • % ...a 3k. - .n .