Loading...
HomeMy WebLinkAbout2905 MAIN STREET ----,,,,q,49 ;47 5-7-----/..1,..,..-_ .e., 147 ' '..-,,,;.'E, . . • . . ... . .„ .. .. . „ . . , •• • , . ,. , , ,, , • • • ... _ , . .. ... . . „., ... . , .. . ., . ......._____,-----. ,, . ... .. . . . „ 1 . .. .... .. 1 .. , " .. . .,.. ... . 1 , . , ..,, . • -.0-• 1 --\,C •' AC- ' - .. . , , . .. .. ..„ . , , .. .. • ... .. . ., .. .. ..,..: 1 - _ .. _ .. .. . . , ., , . „... „ ,. . ..„ , . , .. „. , , , ..... _ .,, ,,. . , .. . ., , .,.., . . „• . ..,„. . . , , , . , .. . „:... ., ,.. „.„. . :4 - ' „,...' ,729 r•' • " x e .; - �r ,i • • . 4" ': • • • v,, .t'- qy�� , • .. 4'r. ..1" .?° , • '^is yk " ° 4.. � +r ,� ,S`.;u • a��. a"?t kC • ,:, .C,', * +' '#, b, T u.h tw 4, Pe':r, w..ih^ "^R-. e%,.` 4 °� . ,cy4Y!b • d � � 'n'f �' ,erns P '`{;,;f : w " G +Y°a.'P.: = irk • .. ,�" _ y*,i, 5 • • s , s m • • • - a ,,. •-r,, y,� r�s '�, -.. 'ice „v..,x'. '4A. "t;x :«4 _4, ,h . r' '' .. '6 kr 's — fir:, rt 1 a .... " .r ,.....�.,., ,•..,.n. -., cr,,,'. ',,..: •" <;s. N.."',', 7'�,a. a..:. .. -' '+, : *a4. rr�P +r«�, ... .�i.: '�. ,Mitif r h4� t '+.,, Y h-''6yy�y, ' ~� •"44 Y!*4' ; s-s '. • , a . r y. •! „ fix pr., - - , $ s •.4 d' 3. r ,� • s "�f r .... .ate — __ - b ' Town of Barnstable *Permit# (51714 o'F r � � Expires 6 month r issue date Regulatory SerVlces Fee �� � EARNSTABLE, • "� Richard V.Scali,Interim Director 639� ♦� �D MA'S� 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 cit (qV 06 Property Address z.q OS ) Ar:A, S 4 d3 A-/ w S ( R3 Residential Value of Work$ 5 20°-0-`3' Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Paz*, 2 9411. .lam'"- SK 4 1- S` C Cc- Contractor's Name aa-ye S' fi'C-e•,. Telephone Number 5 eg. 0-3 7 yfg1 p Home Improvement Contractor License#(if applicable) /53 2 y�_ Email: Ci-fGrc,(/Ct-�A Z.09 Z4)�-/e'1 44�rc` Construction Supervisor's License#(if applicable) j Jd4'/c 7 +40 Workman's Compensation Insurance ""� P �V� Check one: ®�'T �� ❑ I am a sole proprietor ❑ I am the Homeowner TOWN have Worker's Compensation``Insurance Insurance Company Name 6i-'!2(l.¢ . ARN r Workman's Comp.Policy# .bUC . ZO. 000 0' 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 I/,-1.401r2k .L" ' g.Al. ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #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 re 'red. SIGNATURE: Q:\WPFILES\FO S\building pe it forms\EXPRESS.doc fl Revised 061313 Email: L I C. The Commonwealth of Massachusetts Department of Ituhtstrial Accidents ;„1 Office of Investigations ����= 600 Washington Street t� ":r..—r Boston,MA 02111 ^�•;,��'� wniv mass.gow'dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information !/ Please Print Legibly Name(Business/Organization/Individual): ad,5 i'f ' / %4—,-z Address: Zli C (//-"i deb City/State/Zip: - 7.d Y✓►d / Phone ik Safi (9 f 4'5(- 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 6 ❑Neva employees(full and/or part-time).* have hired the sub-conirnctors. 2.❑ I am a sole proprietor or partner listed on the attached sheet 7. ❑Remodeling• ship and have no employees These sub-contractors have g- ❑Demolition. working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp_insurance comp.instrance.t 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 right of exemption per MGL myself [No workers'comp. 12 El Roof repairs insurance required-]1 c.152,§1(4),and we have no employees.[No workers' 13_0 Other comp.insurance required_]; *Any applicant that checks box#1 mast also fill out the section below showing their workers'compensation policy iufnrmati000- Homeowner who submit this affidavit indicating they are doing all work and then hire outside contractors mast submit a new affidavit mriirnting suck tractnrs that check this box must attached an additional sheet showing the name of the sub-contractors and stale whether or not those entities have employees. If the sub-coattactars have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance f jor my employees. Below is the policy and job site information Insurance Company Name: !T 4-1�1 ,,..- Policy#or Self-ins.Lie.#: (:t/C.- C 1 IC ®®47'7 7) 6- Expiration Date: 5 Job Site Address: q°3 • r 4"f I • City/'State/Zip: R_r?i `fr 6 Z.0 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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the finru of a STOP WORK ORDER and a fine of up to 5250_00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerhfy the pains and penalties ofpetjury that the information provided above is true and correct Signature: �'✓� ®- Date: � (fe/ Phone#_ 50Ic9 3 7 q ( G Official use only. Ikr 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 S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 • . . 11 • Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this 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 or other legal entity,or any two or more of the foregoing en: :ed in a joint enterprise,and including the legal representatives of a de,eased employer,or the receiver or trustee of • individual,partnership,association or other legal entity,employ'g employees. However the owner of a dwelling ho e having not more than three apartments and who resides ther . or the occupant of the dwelling house of anothe who employs persons to do maintenance,construction or pair work on such dwelling house or on the grounds or buil• 4:appurtenant thereto shall not because of such emplo ent be deemed to be an employer." MGL chapter 152, §25C(6) • -.• states that"every state or Iocal licensing age cy shall withhold the issuance or renewal of a license or permit o operate a business or to construct buil.'..gs in the commonwealth for any applicant who has not produce." •cceptable evidence of compliance wit the insurance.coverage required." Additionally,MGL chapter 152, §2 C(7)states"Neither the commonwe..' . nor any of its political subdivisions shall enter into any contract for the perfo .•:..•ce of public work until accep •o e evidence of compliance with the insurance requirements of this"chapter have been .resented to the contracting au ority." Applicants . Please fill out the workers' compensation•':•avit completely, . checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), a.a ess(es)and p..one number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)o Limited Li-.ility Partnerships(LLP)with no employees other than the members or partners,are not required to carry wor'-rs' conig ensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this ffida.'t maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Al b sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for th- •ermit or license is being requested,not the Department of Industrial Accidents. Should you have any questions re t; -•g the law or if you are required to obtain a workers' compensation policy,please call the Department at the •u mb. listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town.Officials Please be sure that the affidavit is complete and p .ted legibly. The ►-partment has provided a space at the bottom of the affidavit for you to fill out in the event the ()ffice of Investigatio. .as to contact you regarding the applicant Please be sure to fill in the permit/license numb-.which will be used as a r-•-rence number. In addition,an applicant that must submit multiple permit/license applic, ions in any given year,need o: submit one affidavit indicating current policy information(if necessary)and under"J Site Address"the applicant sho • write"all locations in (city or town)."A copy of the affidavit that has been •fficially stamped or marked by the ci ' or town may be provided to the applicant as proof that a valid affidavit is o. se for future permits or licenses. A new . '•davit must be filled out each • year.Where a home owner or citizen is ob •. •g a license or permit not related to any b iness or commercial venture (i.e.a dog license or permit to bum leave ,etc.)said person is NOT required to complete thi affidavit. The Office of Investigations would like fe thank you in advance for your cooperation and shoal. ou have any questions, please do not hesitate to give us a call. The Department's address,telephone .•d fax number: se Commonwealth of Ma ssachusetls e.• in ent of Industrial Accidents Office of Investigations 600 Washington.Street • Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877 MASSAFE Fax#617-727-7749 Revised 424-07 www.mass_gov/dia . I 1"E T Town of Barnstable ( T \� Regulatory Services * =axxsresrs • Thomas F.Geiler,Director Too 1639• ♦� �Ep ,� - 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, 6 t' , as Owner of the subject property hereby authorize C ,4 F 0144, 103 to act on my behalf, in all matters relative to work authorized by this building permit ,2yos. tvia_:\.- 1111/k (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. S' ner S' tore of Applicant �/ Print Name � Print Name • • Date • Q:FORMS:OWNERPERMISSIONPOOLS 6/2012 ,! i otzlE Town of Barnstable / fe(0). Regulatory Services ST ' Thomas F.Geiler,Director 9 �otot 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 • 1 HOMEOWNER LICENSE EXEMPTI Please Print DATE::.. I JOB LOCATION: numberr street village "HOMEOWNER": name home phone# / work phone# CURRENT MAILING ADD S: _ • city/town state zip code The current exemption for"h eowners"was extended to incl a owner-occupied dwellings of six units or less and to allow homeowners to engage an indi "dual for hire who does not poess a license,provided that the owner acts as supervisor. DEF N OF HOMEOWNER Person(s)who owns a parcel of I d on which he/she reside or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detach d structures accessory/o such use and/or farm structures. A person who constructs more than one home in a two-year period shall not e considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,th t he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) / ' The undersigned"homeowner"assumes r ponsibili, for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. • 1 The undersigned"homeowner"certifies that hi•s e understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she wil comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-familydwellings c ' ntaining 35,000 c ..ic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEO • R'S EXEMPTION The Code states that: "Any omeowner performin I work for which a building permit is required shall be exempt from the provisions of this section(S ction 109.1.1-Licensin: i f construction Supervisors);provided that if the homeowner engages a person(s)for hire to do su, h work,that such Romeo I er shall act as supervisor." Many homeowners who use this exemption are unaware I at they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction .upervisors;Section 2.15) This lack of awareness often results in serious problems,partic arly when the homeowner hires nlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Sup; isor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsib' ' 'es,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 caret amend and adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\ContentOutlook\QRE6ZUBN\EXPRESS.doc Revised 053012 r Ufie.cpo�nvn2oaacvexL�o�G�aczc�iciJeG`(1 _ __ , Office of-Consumer Affairs&'Business Regulation License or registration valid for indrv€dul,use u.7w.;; °— 1•ME IMPROVEMENT CONTRACTOR before the expiration date :,If found return to • 3 Office of.Consumer Affairs and Business Regulation •egistrdtlon_,� �15..792 Type: b 'xpirati n _1/8/2015:.< DBA 10 Park Plaza Suite 51.70. Boston,MA 02116 C&FREMODELING CARLOS FIGUEIROA 20 CAPTAIN NOYES KU: g.�l • S.YARMOUTH; MA 02604 Undersecretary. Not valid without signature'.` Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor :;e. zeo License: CS-104107 'tiM +"� ; 17 ss,‘ CARLOS H FIGURO 20 CAPTAIN NOYES SOUTH YARMOU 0 4 'J J.•G..+ �� �,� ,r.n�•• Expiration Commissioner 08/25/2015 ' .. 0 •. III • • ,.d TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i( ,/ 6 fri& .Map, 2- 79 Parcel 03-3 Permit# �®e/ '� Z813 9 28 Jo 3 Health Division iaw� SQu� vDate Issued Conservation Division 7 2-bl 03 Application Fee alU ° Tax Collector (1/< 7/,2K/09A Permit Fees '?0. Ay Treasurer I/ Planning Dept. Ero Date Definitive Plan Approved by Planning Board CArGlivegit PgRiaiTirIVEW CONS'inuoilotIVISION pada Historic-OKH Preservation/Hyannis Project Street Address ollOS 'oui---c 6,4 Ct1,.,ri, S free -6 Village v�S l e Owner t 4 Li$& 6 61-e.- Address ©t°`OOS- R-00#c- 6 - Telephone D 8) .3 G Z - 36 Z 3 Permit Request l2 es�--c (' o-/ Po rC • /Uri coo+'\j / S /41 ; e p I -c�c w d vas d� %a 4-4 / tex. f�- 6 X /z_' i.0-d Ioar a-bi-, • ►rs-k I00-1-p Pere, / rcp6tc.c SAT Square feet: 1st floor: existing `6S2 proposed /716 2nd floor: existing /77 proposed Total new 33 IS— Zoning District Flood Plain Groundwater Overlay Project Valuation 2 2, I SG Construction Type Lot Size / • 03 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family i Two Family ❑ Multi-Family(#units) Age of Existing Structure /6'.3 Historic House: ❑Yes 1114) On Old King's Highway: s ❑No Basement Type: ❑Full ❑Crawl ❑Walkout T ther-t'II irce--e-YZ / Cra-ks> Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 6 / r &c/ 67 -F- * Number of Baths: Full: existing new Half: existing / new Number of Bedrooms: existing 11 new Total Room Count(not including baths): existing /J new First Floor Room Count Heat Type and Fuel: 1-.As ❑Oil ❑ Electric ❑Other Central Air: e@r Fireplaces: Existing 2'. CA'No New Existing wood/coal stove: Ves ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:1f existing ❑new size 30X -30 Attached garage:0 existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes tf No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name o cc> >✓ Telephone Number "7 / L Address License# • Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0, �v��S SIGNATURE — DATE 7j /Ftff3 i FOR OFFICIAL USE ONLY .. PERMIT NO. _ ... tl DATE ISSUED . MAP/PARCEL NO. -• ;"' i . ADDRESS ' * VILLAGE OWNER f DATE OF INSPECTION: �C� FOUNDATION 0 f -1/' s /V wx . `s FRAME ®� /dq,� leigile _ r . INSULATION ;p:f m`'04" 001/009 1.4g , - r FIREPLACE r. • , , i ELECTRICAL: ROUGH FINAL • PLUMBING: ROUGH FINAL r y GAS: ROUGH . - FINAL �,,r'` `- FINAL BUILDING - r'r It 4 ' r DATE CLOSED OUT . OR f Y 1 ASSOCIATION PLAN NO. -D .. . y , .. r