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Home My WebLink About0440 LINCOLN ROAD EXTENSION ;� �. L Town of Barnstable SHE r�,ti Building Department Services Brian Florence, CBO t RlRucrlAL4 . Building Commissioner MAS3 165 w 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma us Office: 508-862-403 8 Fag: 508-790-6230 pFRMTT# D : $35.00 SE00 REGISTRATION RESIDENTIAL ONLY 200 square feet or Iess Location of shed(address) V-illagau Property owner's mmne Telephone number 1 D Size of Shed Map/Parcel# 0S IG 19 Date i BUILDING DEP Hyamus Mam Street Waterfront H"istonc Distnat? Old Kings Highway Historic District Commission jaisdiction? SEP 6 2019 You must file with Old King's Highway Conservation Commission(signature is required) TOwN OF'BARNSTABLE Sign off hours for Conservation& 1-9*31&3:304 30 . PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION M. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THMS FORM MUST U ACCOMPANIED BY A PLOT PLAN Q-foams-sbedreg REV:08/6/17 z; Le end A ? i. Parcels ti Town Boundary Railroad Tracks j � \ � �R Buildings 3 Approx.Building Buildings \ Painted Lines b, 271029 Parking Lots G E n 4 Paved Unpaved s Driveways 3,. Paved Unpaved \ , Roads El�. �� '•m `, `; Paved Road Unpaved Road Bridge - �, Paved Median Z � a > Streams { Marsh " Water Bodies 271030 4 C y c r f �ar7n 18 gg 1271117 (rjj s 6 #191 (f t• 1 Elf, \`",.Y' �'k � 'MA� ❑� .. Map printed on: 9/16/2019 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026oi O 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: 1 inch= 21 feet cartographic errors or omissions. gis@town.barnstable.ma.us f oP a re �� Town of Barnstable *Permit# �;z o5g a3�b Fxpires 6 montlis from issue date BARN reet.e. Regulatory Services Fee o OD Thomas F.Geiler,Director 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 uMap/parcel Number a� ' Property Address residential Value of Work v,-)OG , 00 Minimum fee of$25.00 for work under$6000.00 e r Owner's Name&Address ` bac-bOn LJA�d n V-0jCA Contractor's Name ff C ( I QiMW Telephone Number Home Improvement Contractor License#(if applicable) � j � Construction Supervisor's License#(if applicable) m Workman's Compensation Insurance Check one: -PRESS PERMIT ❑ I am a sole proprietor ❑ I.=the Homeowner J U N 2 4 2008 have Worker's Compensation Insurance Insurance Company Name —� TOWN OF BARNSTABLE t �� a Workman's Comp.Policy# CyjG�A L q 2'`� Copy of Insurance Compliance Certificate must be on file. V ° Permit Request(check box) G �� Re-roof(stripping old shingles) All construction debris will be taken to , ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *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. Home Improvement Contractors License is required. SIGNATURE: //A QTorms:cxpmtrg Kevise071405 The Commonwealth of Massachusetts ' Department of Industrial Accidents ,tom;, t Office of Investigations E '� 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): Address: 0 fa)i "� City/State/Zip: � CAhone 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 have hired the sub-contractors 6. ❑New construction employees(full and/or part-time).* 7. ❑Remodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. workers' comp. insurance. Y P tY• 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑Roof repairs insurance required.]t 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information.Insurance Company Name: — c Policy#or Self-ins.Lic.#: l — Usq —0 Expiration Date: C) Job Site Address:4_4() t—AY\,60 '0 01L11 . Ci1�l.'�� City/State/Zip: �( Attach a copy of the workers' compensation policy declaration page(showing the policy numbe nd 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: , Town of Barnstable A �iARN31' BLE, f59. Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, ��l�U ► ` � � ,as Owner of the subject property hereby authorize A to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Da e , n Print Name I Q:Forms:expmtrg Revise071405 AC- ,. CERTIFICATE OF LIABILITY IN URANCE 6 24N2o®' FRODurER (617)354-4640, Fax(617)354-5829 THIS CERTIFICATE 18 188UED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE T. Edmund GaLrritY & Co. Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EX`'I'END OR 545 Concord Ave. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Cambridge MA 02138 INSURERS AFFORDING COVERAGE NAIC 0 INSURED IN RERA:9cottsdale Insurance Co. Mark Lemon INSURER B:CC1MZQrce Insurance Co. dba NL and son Construction INSURIIRC!The 3artford PO Box 423 IN$U west Hyannisport MA 02672 INSURERE: FRAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 I EE CREMIGER BY PAID QLAIMS IN BR ADD'L POLICY EFFIOTIVG POLICY EXPIRATION LIMITS TYPE of INSURANCE POLICY NUMBER TE MM/D TB MM! IYIr GENERAL LIABILITY CL91491217 05/16/2009 05/16/2009 PiSCH OCCURRrU r a 1 000,000 DAMA RENTED 50,000 X COMMERCIAL GENERAL LIABILITY oggUrrarleal A CLAIMS MADE ❑X OCCUR e e 51000 X $1,000 Deductible PrRSIONAL&ADY INJURY 1 1,000,000 012NERALAGGREGATE 0 2,000 000 GEN'LAGGREGATELIMITAPPLIESPER PRODUCTS l 000 000 R - PO P AUTOMOBILE LIABILITY 33STLT 06/14/2006 06/14/2009 COMBINED SINGLE LIMIT a 1,000,000 (Ea acolaent) ANY AUTO 8 ALL OWNED AUTO$ BODILY INJURY o (Per person) X SCHEOULEDAUTOS X HIRED AUTOS BODILY INJURY e (Per aoclder�) X NON•OWNEDAUTOS PROPERTY DAMAGE !a (Per eeoldenp GARAGE LIABILITY AUTO ONLY•EA ACCIDENT e ANY AUTO OTHER THAN AUTO ONLY: EXC9801UMBRILLA LIABILITY OCCUR CLAIMS MADE R I PDEDUCTIBLE e RUrnNTION 8 C WORKERS COMPINIAT10N AND UB-059AL42-3-08 03/19/2008 03/18/2009 Y TAT . OT - IMPLOYERO'LIABILITY E&HAPOIDRNT 0 100,000 ANY PROPRIETOR/PARTNERJEXECUTIVE OFFICER/MEMBER EXCLUDEW) E L DI b EMPLOYEE 100,000 Ir yes.describe ureer DISEASE,PO 500 000 belowSPECIAL PRO IONS OTHER DESCRIPTION OF OPERATIONBILOCATIONBNEHICLIVEXCLUOICNe ADDED BY ENDORSEMENTIOPECIAL PROVISIONS The workers' compensation policy doom not provide coverage for stark Lemon. CERTIFICATE HOLDER CANCELLATION (508)962-4784 8HOULD ANY OF THE ABOVE DESCRIBED POLICIES O! CANCELLED BEFORE THE Town Of Barn®table EXPIRATION DATA THIRGOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 200 Main St 10 we WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,GUT Hyannis, MA 02 601 PAILURG TO 00 80 SMALL IMPOSE NO OBLIGATION OR LIABILITY OF.ANY KIND UPON TWO INSURER ITS AOINTJ,OR RIPREOGNTATIV IAUTHORIZED RGPRESGNTATIVE WI[Ijam Gerrity/KATHYI ACORD 26(2001/08) 0ACORD CORPORATION 1986 IN5026pin).0ee Page I of L00/I.0012 AII88V9 ONnNO3 1 8Z8 V9U1.9 XV3 bL :SL 80OZ/VZ/90 pp i� -- — _ fie T000rvnwoU pear o�✓�aaaaclu�aelia Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration.-,,136160 One Ashburton Place Rm 1301 Expiration=6/,19/2010 Tr# 268135lug Boston Ma.02108 s# Type In,8,1'idual MARK LEMON ( , d A \ x r = r•: MARK LEMON 490 PITCHERS WAY "`X- ' Not valid without signature HYANNIS,MA 02601 Administrator o- DELIVERY NEEDED FOR DAY/ DATE: TIME: NAME: JOB LOCATION: ORDERED,:BY� pHONEr TAKEN.;BY� ;DATE%TIME � z,.k'sts�va3x Y°�p?'�4 ,k✓.ua..tp..tea :l �+vHYm . s4x 9"/z !Maple , k MU2 ilzf r, +i fk: 'X y_ TOWN OF BARNSTABLE BUILDING DEPARTMENT i 1 HOMEOWNER LICENSE EXEMPTION Please print. DATE 3`7 z JOB` LOCATION d nco/�,, :. Number Street Address Section Of Town r / "HOMEOWNER' .I / �_c�`a- / 7.7f--=�� 7 i Name. Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for "homeowners" was extended to include owner- occupied dwellings of six units or less and tolallow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) 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 to six family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than done 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) i The :undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and . regulations. The ,undersigned "homeowner" certifies that he/she understands the Town of. Barnstable Building Department minimum inspection procedures and requirements 7t; HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Y'F Notes Three family dwellings 35,000 cubic f eet,i or required to comply with State Building Code Sec will be Control. tion 127gOr�Construction MZSCS a HOME OWNER'S EXEMPTION The code states that: "Any Home Owner 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 Owner shall act as supervisor. " Many Home Owners who use-this exemption are unaware that they are assumin the responsibilities of a supervisor. (see Appendix Q 9 Ru fob' Licensing Construction Supervisors, Section 2. 15) . Thisalackeofl5atons awareness often results in serious problems, particularly when the Home `' Owner hires unlicensed persons.. In this; case our Board 'cannot proceed against the `unlicensed. person as it would withlicensed supervisor. The Home Owner acting as supervisor is ultimately responsible.' To ensure that the .Home Owner. is full aw are of m Y his/her an re s co ons communities ibil i it Y ties P yes re quire, as part of the permit application t � me Owner certify that he/she understands the responsibilities of aasupervisor. 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. i Y' :r f 4, 1 A IY Y k r% e 4� it t: Lq S : Z X(o w�rEJ4d�G�Q.s - •. EEC �� .�, 1-7 it ' � __� .•�y _� a "�, ....+� �.rs.�� _ �,.s�...;�� «s3�-P:, _ --:eL:.�:..i9�..-��!!'� � ,•mfwal �+a»w.�+:--r: --. •••.�',i _ _� a s . ° : # " Assessors office(1st Floor): Assessor's map and lot number1 — C7 S-rEpA ,a�o�+f o�TN E To ` Conservation Board of Health(3rd floor): ��y^'��1,�, s � f'� • Sewage Permit number Coot�o AND Desty ant Engineering Department(3rd floor): °o ie70• House number " C�rL �'Y7 �� RiE�vtA-TIONS Ito es�r. Definitive Plan Approved by Planning Board 7-- ® APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only 3S2 3 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION - �3 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: '7 7 Location d L i�/�GG/✓1 pt�/ a�G�t� �•1 Proposed Uses--/,'�� Zoning District Fire District dtA-z" Name of Owner Le.a V eu e_ c�� Address 23� �� a Jv-1 Name of Builder Address Name of Architect Address — Number of Rooms " Foundation // u✓t Exterior t/rnicy. + S'Le-0 Roofing h�� Floors '— Interior Heating Plumbing Fireplace Approximate Cost v' fly O Area Diagram of Lot and Building with Di ions L A(S46w-E Fee ' 6,y0/ 7 6�- ---/Zf-� Ago �fiv 00 �d OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS Ihe reby agree to conform to all the Rules and Regulations of the Towrnof Barnstable regarding the above construction. Name L2 Construction Supervisor's License - T BACHAND, LIONEL 1i35-0\ No 35232 permit For BUILD CARPORT ADDITION Single .Family Dwelling Location 440- Lincoln Road Extension , Hyannrs , w f - r ✓. Owner Lionel Bachard r Type of Construction' Frame `.-. i - Plot ' Lot C Permit Granted ' July 29 , 19 92 - Date ofjlrpectir 19 i _ ;-- Date Goo lete 19 k. - ..- K,R if.1 ~ t ,. ` I t _