HomeMy WebLinkAbout800 BEARSE'S WAY (8) �� •�
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o*INN Printed On:7/9/2020
04 Complaint Call Report
'"RMANA
;,� 800 BLDG 2 UNIT 2ND BEARSE'S WAY,
HYANNIS case# C 201ss
Case#: C-20-139 Address: 800 BLDG 2 UNIT 2ND Date: 4/21/2020
BEARSE'S WAY, HYANNIS
Owner Info: Property Info:
MBL:
Owner Notified?:
Complaint Details:
Type of Complaint Classification of Complaint Method of Complaint
Building Code Medium Priority Phone
Complaint Summary.
Report of work without a permit in this unit. Complete remodel.
Action History:
Action Taken Date Description Fee Inspector
Close Case 7/9/2020 No violation present $0.00 bowerse
Inspector Assigned to p g Complaint. bowerse Fled by: sheas
Comments:
Comment Date Commenter lComment
Dater 7/9/2020 Town of;Barnstable.
y
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel 4CvJ 0 A F Application #
Health Division Date Issued
Conservation Division Application Fee T9
Planning Dept. Permit Fee Av
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation/ Hyannis
Project Street Address
Village
Owner i Address o �� sob
Telephone ,
Permit Request � � 1 ���� yG� � ,o �.� os
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood-Plain Groundwater Overlay
Project Valuation JS b d Construction Type 2L_64W,46
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 ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ier �aZ
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
(�B/UILDER OR HOMEOWNER)
Name �lSr4 ® '�I�LfS� Telephone Number
Address % & ✓ 4Sl��1o9 License �-
S,Q AA 10(C VI Da.g-Z 3 Home Improvement Contractor
6S� C/'L 2. Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE �/� & /�
!l
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
9
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
r ,
,f
FRAME
t INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
t GAS: ROUGH FINAL
FINAL.BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
The Commonwealth of Massachusetts
Department of Industrial Accidents
' Office of Investigations
' 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):�abbw ,:1'c, D/1� D 'la� er ,eC01,S+S
Address: A/� :ran ` b95 tan ]b r i ue,
City/State/Zip: wl^ Phone#: 8 /
Are you an employer? Check the appropriate box: Type of project(required):
11 I am a employer with to 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. Eliemodeling
ship and have no employees These sub-contractors have g, ❑ Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp.insurance. 9. Building addition
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 I I.❑ 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' 13.0 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: zur'ch-Ann
r ,
Policy#or Self-ins.Lic.#: " /a 9 P ! O Expiration Date:
Job Site Address o? // > City/State/Zip: A- i'd-4 I'd llz_ 111,4,pwgf,&!nr S
Attach a copy of the workers'compensation policy d eclaration page(showing the policy n ber and expiration date).
Failure to secure coverage as required tinder 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$250.00 a day against the violator, Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the.DIA for insurance coverage verification.
I do Hereby cer if un a the pains andpenalties ofperjury that the information provided above is true and correct.
Signature.
Date:
` Phone#:
Official use only., Do not write in this area, to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
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'"��r yee� '�1�o��s• �r+Y ,+t� � n, r s r �1 %.a vj�a�,.i€r,�r T,r c,r',�{x,$.F ISSUE DATE
12122(2011
THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTSFICA HOLDER THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVCLY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED THE POLICIES
BELOW,THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE I8811ING INSURER(S)�UTHORM
REPRESENTAnVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pol]Wles)must be endorsed,if SUBROG TION IS WANED,subject to the
terms and conditions of the policy,certain policies may require an endorsement A statement on this certificale d es not confer rights to the
certificate holder In Hsu of such endorsement a.
PRODTJCF,B CONTACT
OCEANSIDE INS GROUP NAME`
NE
52 WEST MAIN STREET A/C,No,Ext: (AJC,No):
HYANNIS,MA 02601 E-MAIL
ADDRESS:
PRODUCER
CUSTOMER ID R
INSURED INS S AFFORDING COV)ItAOE NAIL tF
BENABBY INC DBA INSURER A ZURICH
DISASTER SPECIALISTS INSURER B
P 0 BOX 480 INSURER C
SANDWICH,MA 02563
INSURER D
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED MINE INSURED NAMED ABOVE P R IRS POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIliVMNT,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 IB:REW IS SUBJECT TO ALL THE TERMS,E XCLUSIONS AND CONDIIHONS OF SUCH
POLICIES.LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS,
INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY E LE&TS
LTR INSR WVD I
GENERAL LIABILITY i EACAOCCURRENCE S
s
O C010MCW.OENERALLU,BJLITY PREMISES(Eech :
ownence
MED,EXPENSE Wy one S I
Q CLALMS MADE 0 OCCUR Perm
0 PMSONAL&ADV f
INJURY
(1 1 OENERAL AGOREOATE S i
OEWL AGOREOATE LD43T APPLIES PEP
' PRODUCTS-CoMP/OP S I
0 POLICY 0 PROJECT O LOC AUG
AUTOMOBILE LIABILITY COMBBSED SINOU S
LIMIT
ch eccldenl
0 ANY AUTO BODILY INJURY S i
M Pers
BODILY INIDRY S l
0 ALL OWNLO AUTOS et Accident)
O SCHEDULED AUTOS PROPEM DAMAGE
SCHEDULED S :
er atc,dmt i
0 KREDAUTOS S
0 NON•OWNFD AUTOS S
0
0 UMBREU ALIPB 0 OCCUR I EACH OCCURR_NCE S
O ERCESSLLAB O CLAIMS-MADE AGGREGATE, S
0 DEDUCTIBLE S
0 RETENTION S S
WORKERS'COMPENSATION WC
A AND EYOLOYEIIS LIABILTFY NIA STATUTORY
Y!N j LUI S
ANY PROPRMTORRARTTfJV I
EXECUTNE OFFL1-MULNdBER N NIA 6ZZUS-g102P700 O110U12 O!lO1/l3 LDMEASE-POUIC,
CCIDENT $500,000
i
(MMA ORYINNH) � -_H 5500,000
i
rr yos,dourk mdor DL•SCRWRON OF $500,000
OPERATIONSbelow
U¢RCRIPTION OF OPBRATIONB/LOCALtONAIVFIi1CLE9(ANach ACOAD TOIL Addilioml Remerks Schedule,irmore spMe a requiceA) '
THF.INWREII'8 MA'JlORY.ERS COMPENSATION POLICY AND rrs LazTE.D OTNER STATES INSURANce EFTDomw2rr AUIHORIEES TJM PAYmEwT'OF BENEFITS FOR CLAUS MADE BY THZ,INSURED'
F-\GLOYEES IN STATES OrM THAN MA NO AUTHORIZATION IS MEN TO PAY CLAIMS FOR BENEFITS IN ANY STATE OTHER THAN MA IF THE RMURID HIES,OR HAS HRED,EMPLOYEES OUTSIDE
` Mk M POLICY DOTS NOT PROVIDE COVBRAOE'OR AITY STATE OTHER THAN AEA
THIS REPLACES ANY PRIOR CERTIFICATE 189DED TO nM CERTIFICATE HOLDER AFFFCTTNG WORKERS C LSP C'OVERAGR
�,CFRT.�11`,��� ��8,:','cY;,..�,,,,o,iaSx,i,...�.�;Y ;,`.?;:.:,x:'� �§ya a Gplll ulfiE. .rY ll:•�. .;_: �,. � : - -,��::a`,m �'�;�SrS�a;<i•;
SHOULD ANY OF THE ABOVE DEBC ED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,N TICE MALL BE DELIVERED IN
ACCORDANCE MAIN THE POLICY PR VISIONS.
AUMORM ROTE MATIVE -
� BYGRYY I"1GIC�.eGt9V
. ..., � TINKw sses oo co "'"I�a�'M[
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Massachusetts-Department of Public Safety
Board of Building Regulations and Standards
Construction Supen•isor
License: CS-071402
JO 10
5)3UA L COIN _ w�
r.
1082 OLD STAG
+
CENTERVE�IX
%
V
�,a Expiration
Commissioner 12/31/2013
3
c
�po�i�z��zcvizcuea�G�
Rice of Consumer Affairs& eri
Business Regulation
ME IMPROVEMENT CONTRACTOR License or registration valid for individul use only
before the expiration date. If found return to:
e ra o tQ8642 Office of Consumer Affairs and Business Regulation
" Expiration'-8T20/2014; TYPe''
10 Park Plaza-Suite 5170 g
BENABBY INC/DISASTER.,SPECIALIST' Supplement 4:ard Boston,MA 02116
1 k mt�
JOSHUA COHEN
Box 480
,z :n
Sandwich, MA 02563
Undersecretary
Not valid without signature
DIME l°y� Town of Barnstable
Regulatory Services
y 'ssBlE Mg Thomas F.Geiler,Director
TFDMA�a 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, 140.1/1LAV 11adb 'LI —rll. , as Owner of the subject property
hereby authorize e- to act on my behalf,
in all matters relative to work authorized by this building permit.
00 ecie'TZ:5 41 Ad � .2 h/ya��,
(Address of J b) !
**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.
SL'gmatur o wner ature of Applicant
tin JY a)
Print Name Print Name +'
Date
Q:FORMSDVINERPERMISSIONPOOLS 6/2012