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3087 MAIN STREET
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Date Issued fi-oe -_/6.ggi Conservation Division OCr27 as Application Fee Planning Dept. . � T®V © I/N Permit Fee 1 O DU Date Definitive Plan Approved by Planning Board or Hist�c OKH _ Preservation/ Hyannis Project Street Address , 30g 7 , i c_57 C e llage_ L ,6.6�, 7'1-6ti� Owner. --\ ~�179 L4._ fgs fv�cw c j(sciiAAddress' 06 ?a /Mk,S 23i4s�o 1'd arc..,/)1A Telephone___ 71 3"d£i 7PC --348 C.i6rf bacii) CPer-mit-Request 7,0-,844/A I90tio 7 f,OI 4`a2444--- di Zess7d- ?od C S i%ivG4F.S Wee , C sp f_si(av Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District I Flood Plain Groundwater Overlay Project�Valuation d.lv. 1-6\-- 15 r35. Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes U 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 1 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: 0 existing Cl 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- t)- g- Me/9 s6 Ugiza e-., LTelephone=Number,-SQB `` 3O ` sd �Adiii.E ` 7 166,7-- 'Z License#-- _5_ - 0 `i' L;--O 4lifilmaori) / a z4.7/ H mo e_lmpr-ovemen#�Cont�_ r__ actors# //7�b`Z f ariTar7_)7Tri ow G4P4caD 0--yliik . C.aP1 iWorkerrs Compensation:# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,_9 7":r AVA ..7 /1/1,1til.> All C_SIGNAT_URE_ 7 g pre . 1..DATE_,_., 6 2 w. i Ij • t + FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE = OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE .-ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r. FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. • / • The Commonwealth of Massachusetts I! =�/ Department of Industrial Accidents c 2-..--7.,,, _; Office of Investigations �= '_-• 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /J -� Please Print Leiibly Name(Business/(kganimation/htdividual): �J� Ante /,QSWi14A.) c.1 G Address: /.< il4 &iT /LCi't- City/State/Zip: iexcr 16fhaa,# P/f 020 Phone#: ,.vt/ ' /43° —SaSd Are you an employer?Check the appro rate 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).* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' insurance.: 9. Building addition m [No workers'comp.insurance p required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their II. Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12. Roof repairs /insurance required.]t c. 152,es [ we have no employeees..[Noo workers' 13.7Other�,Eki lc s comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers compensation policy information. 1 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 has e employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 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.Lie.#: _ 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 the ins a hies of perjury that the information provided abov is true and correct. Signature: �i r pies. Date: / "' /(o Phone#: _cad- ¢3a -.SGSa Official use only. Do not write in this area,to be completed by city or town official. ('ity 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in 'oint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an indivi. ,partnership,association or other legal entity employing employees. However the owner of a dwelling house havin not more than three apartments and who des therein,or the occupant of the dwelling house of another who em• oys persons to do maintenance,constru' ion or repair work on such dwelling house or on the grounds or building app •ant thereto shall not because of suc employment be deemed to be an employer." MGL chapter 152,§25C(6)also states • "every state or local licens g agency shall withhold the issuance or renewal of a license or permit to operate business or to construe l ulldings in the commonwealth for any applicant who has not produced acceptab -evidence of complian. with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)state "Neither the comm. wealth nor any of its political subdivisions shall enter into any contract for the performance of pu• is work until ac• ptahle evidence of compliance with the insurance requirements of this chapter have been presented is e contractin authority." Applicants Please fill out the workers'compensation affidavit compl - ,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es) : • 'hone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limi Li. 'My Partnerships(LLP)with no employees other than the members or partners,are not required to carry worke corn. 'on insurance. If an LLC or LLP does have employees,a policy is required. Be advised that th'. affidavit may . submitted to the Department of Industrial Accidents for confirmation of insurance coverag Also be sure to s : and date the affidavit. The affidavit should be returned to the city or town that the applicat.n for the permit or lice is being requested,not the Department of Industrial Accidents. Should you have any q - tions regarding the law o ' you are required to obtain a workers' compensation policy,please call the Dep.- ent at the number listed below. Self-insured companies should enter their self-insurance license number on the app •priate line. City or Town Officials Please be sure that the affidavit is co plete and printed legibly. The Department has 'rovided a space at the bottom of the affidavit for you to fill out in . e event the Office of Investigations has to contact ou regarding the applicant Please be sure to fill in the permi cense number which will be used as a reference num . In addition,an applicant that must submit multiple permi icense applications in any given year,need only submit o affidavit indicating current policy information(if nece and under"Job Site Address"the applicant should write"al ocations in (city or town)."A copy of the affidav that has been officially stamped or marked by the city or town -y be provided to the applicant as proof that a va d affidavit is on file for future permits or licenses. A new affidavit st be filled out each year.Where a home own or citizen is obtaining a license or permit not related to any business or •mmercial venture (i.e.a dog license or . it to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Inv.. igations would like to thank you in advance for your cooperation and should you have any questions, please do not . -mate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel.#617-7274900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia J Massachusetts -Department of Public Safety • Board of Building Regulations and Standards Construction Supervisor n per License: CS-0 0503 „, MARK M MCGOWAN., 15 RABBITT RUDE f r'� WEST HARWIC$ ' e,IVIVI ...: �-.+� .. " "' s Expiration Commissioner 03/11/2017 • <� ffi eornrr+n"tweet/r�r/C'`,'�r JJgr/rrueh,I ce of Consumer Affairs& Business Regulation a ME IMPROVEMENT CONTRACTOR II �; gistratlon: 119582 Type: xpiration: 8/1/2017 Private Corporatir M.J.M.AND ASSOC. INC. MARK M. MCGOWAN 15 RABBIT RUN W HARWICH,MA 02671 Undersecretary Mass. Corporations, external master page Page 1 of 2 R "" William Francis Galvin Secretary of the Commonwealth of Massachusetts Corporations Division Business Entity Summary ID Number: 042600860 Request certificate I JNew search I Summary for: BARNSTABLE HISTORICAL SOCIETY, INC. The exact name of the Nonprofit Corporation: BARNSTABLE HISTORICAL SOCIETY, INC. The name was changed from: HISTORICAL SOCIETY OF THE TOWN on 10-14-1998 Entity type: Nonprofit Corporation Identification Number: 042600860 Old ID Number: 004600860 Date of Organization in Massachusetts: 08-28-1940 Last date certain: Current Fiscal Month/Day: / Previous Fiscal Month/Day: 00/00 The location of the Principal Office in Massachusetts: Address: 3087 MAIN STREET PO BOX 829 City or town, State, Zip code, BARNSTABLE, MA 02630 USA Country: The name and address of the Resident Agent: Name: Address: City or town, State, Zip code, Country: The Officers and Directors of the Corporation: Title Individual Name Address Term expires PRESIDENT RICHARDS FRENCH ACRE HILL RD BARNSTABLE, MA 06-01- 02630 USA 2017 TREASURER JOE BERLANDI 3180 MAIN STREET BARNSTABLE, 06-01- MA 02630 USA 2017 CLERK MAX KUMIN 3826 MAIN STREET CUMMAQUID, 06-01- MA 02637 USA 2017 VICE PENNEY HENSLEY 34 SWALLOW HILL DRIVE 06-01- PRESIDENT BARNSTABLE, MA 02630 USA 2017 DIRECTOR JAMIE HUNSAKER 312A COMMERCE ROAD 06-01- BARNSTABLE, MA 02630 USA 2019 http://corp.sec.state.ma.us/Corp Web/CorpSearch/CorpSummary.aspx?FEIN=042600860... 10/20/2016 Mass. Corporations, external master page Page 2 of 2 DIRECTOR ROBERTA Q. COX 2864 MAIN STREET BARNSTABLE, 06-01- MA 02630 USA 2019 DIRECTOR PENNEY HENSLEY 34 SWALLOW HILL DRIVE 06-01- BARNSTABLE, MA 02630 USA 2018 DIRECTOR JOE BERLANDI 3180 MAIN STREET BARNSTABLE, 06-01- MA 02630 USA 2017 DIRECTOR TARA SCHIFFMAN-BROWN DEACON CT BARNSTABLE, MA 06-01- 02630 USA 2018 DIRECTOR NANCY V. SHOEMAKER 21 MEADOW LN W. BARNSTABLE, 06-01- MA 02668 USA 2018 DIRECTOR RICHARDS FRENCH ACRE HILL RD BARNSTABLE, MA 06-01- 02630 USA 2017 DIRECTOR MAX KUMIN 3826 MAIN ST CUMMAQUID, MA 06-01- 02637 USA 2018 DIRECTOR NANCY WEIR BOX 222 BARNSTABLE, MA 02630 06-01- USA 2017 DIRECTOR JOHN G FLORES PH.D 83 KEVENEY LANE CUMMAQUID, MA 06-01- 02637 USA 2019 DIRECTOR ROBERT DWYER 174 SALT ROCK ROAD BARNSTABLE, 06-01- MA 02630 USA 2017 DIRECTOR MAUREEN DWYER 174 SALT ROCK RD BARNSTABLE, 06-01- MA 02630 USA 2018 DIRECTOR WILLIAM CROCKER 50 BIRCHILL RD CENTERVILLE, MA 06-01- 02632 USA 2018 ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual Report A Application For Revival Articles of Amendment Articles of Consolidation - Foreign and Domestic •il 1 LI+-.---IIJ-LI 1'� LI J f� LI View filings I Comments or notes associated with this business entity: A V New search I http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=042600860... 10/20/2016 Ct„e Town of Barnstable Regulatory Services i n1*p„t,�,p� Richard V.Scali,Director Ituttibes9-Wet Building Division Paul Roma,Building Commissioner 200 Main Sheet,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 ei I, r✓� I( 7 Ms �� , as Owner of the subject property hereby authorize , 7 /47 "kV su '-7 to act on my behalf, in all matters relative to work authorized by this building permit application for. 8? 1/r'✓ ,34X,,„ST/fr7 Clz# nvl (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be •, - . or utilized before fence is installed and all final inspections - •lit ormed and accepted. Sigthture of Owner f plicant PAnt Name Print Name /O Q:FORMS:O WNERPERMISSIONPOOIS 11111 Town of Barnstable a , Regulatory Services 4n Thomas F. Geiler, Director • s<�B� Building Division 1110,MA83. 1679. I Thomas Perry, Building Commissioner Eo 6. 200 Main Street, Hyannis, MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 August 20, 2010 Marilyn C. Fuller Barnstable Historical Society 3087 Main Street Barnstable, MA 02630 Dear Ms. Fuller, In response to your request dated August 17, 2010 to display and open flag in front of 308? Main St, Barnstable Village, Tuesday through Saturday from mid June to mid October has been approved. If you require further assistance, please do not hesitate to contact me. Sincerely, C / Thomas Perry, CBO Building Commissioner -. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map0/9 Parcel � � Application #0O1 2C9 pp Health Division Date Issued 1 ( • 1 Conservation Division Application F Planning Dept. ! Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address C $'7 ka. n = Village Cpsa r h sleet to Owner Gas v's •'able is aricc�Q-�c e Address 3o 7 Ha e'n act- flat Telephone ,3(ea -c O7 (,kn .-i . ( a Pvr �� S Permi m eg0St r?cE — Cc �C.3-° -� C'� g cat Cc cut Lockvic /Up ii \ ; [ v e C.4 vc-kcx - a Squareettst floor: e sting proposed 2nd floor: existing proposed Total new ZoningIlistrgt Flood Plain Groundwater Overlay Projecalugon Construction Type Lot Size Grandfathered: U Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full U 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 U No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size Barn: U existing ❑ new size_ Attached garage: Cl existing ❑ new size _Shed: ❑ existing U new size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes p❑ No If yes, site plan review # Current Use reSk c�e Proposed Use I S6r t Cc_z ref-Pa cc_14 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name l3C0rr•cL le tt .r 1. Soc e47 Telephone Number 96 mod? C 1 -44r j t "Fa-(der" Address License# e 7 Noti‘o 5+; Bru;(10,,k2 Home Improvement Contractor# • Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNAT fi✓r C DATE 19 26 (6 - r t Az FOR OFFICIAL USE ONLY : # } ''APPLICATION ... .. DATE ISSUED. MAP/PARCEL NO. : _ • _ _ e i C . . , ADDRESS - VILLAGE OWNER - - , • . . ' . . 1 . . - DATE OF INSPECTION: c- ..: V FOUNDATION' -: , ..- : -1- - ( . . , . FRAME 1 , INSULATION i ,-•,q-,1 '•1,1 FIREPLACE - ELECTRICAL: ROUGH FINAL • ., . PLUMBING: ROUGH - FINAL i t . GAS:;! r. —ROUGH c;.'i.,4`Ctz ,-i 1---/, FINAL . -. - FINAL BUILDING J • :NA ! iiC: • • 1 .. t , ! -,t • , DATE CLOSED OUT . ; --, . ... ASSOCIATION PLAN NO. .,