HomeMy WebLinkAbout0045 PHILLIPS ROADF"Y� �Ph� lips �cf .
f
_1 `1
�1"WE Town of Barnstable *Permit#�/-TVIN�O
sly' " Building Department F.xQires6,nonthsjromssuedate
BABNSTABLE, : Brian Florence,CBO r eC
MAW �' Building Commissioner (� C6
o
200 Main Street,Hyannis,MA 02601 �r.P a
www.town.barnstable.ma.us �?
Office: 508-862-4038 /-0 10-790-6230
94
EXPRESS PERMIT APPLICATION - RESIDE LY
Not Valid without Red X-Press Imprint L
Map/parcel Number qq� Od�J (.�
Property Address L1 5 Pk l k, s R a) N U G h n is MA
esidential Value of Work$ q R'O 0 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address a U.A ll S4m A -[)
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable) Email:
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
[dram 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 R t(check box)
eque2Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken tojr ��rs )
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
rR❑ -side
eplacement Windows/doors/sliders.U-Value 0A ersem 4ob (maximum.32)#of windows_L
#of doors:
*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: '
i
C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\9NNOKXYW\RESIDENTILONLYEXPRESS.doc
09/26/17
The Comynormwahk of Massachusetts
Lhgwrhnmt of Ind strial Accidm&
QKwe of Investigaiaons
600 Washington Stmet
Boston,MA 02111
wfwrv.ma5s.g0V1dis
Workers'Compensation Insurance Affidavit Bu'dtiers/Co ctors/Ekectricians/Plumbers
Antalicant Inforniatim Please Print Legib y
Name
Address:
City/State/Zip: Phone#:
Are you an employer?Check the appropriate box: T of project
4. I am a general contractor and I YFE P l (�'e4��=
1.❑ I am a employer with ❑ 6. ❑N construction
employees(foil and/or part-time)s have hired the sub-contractors
2.❑ I am a sole proprietor or parto- listed on flee attached sheet 7.
Iing
ship and have no employees These sub-contractors have S. ❑Demolition
woddng for me in any capacity. employees and have wodkees' 9. ❑Building addition
[No workers'comp.insurance comp.insuramml
i 5. ❑ We are a eofporation and its 10.❑Electrical repairs or additions
3.69 I am a homeowner doing all wodr officers have exercised their 11.❑Plumbing repairs or additions
[Noworkers'comp. right of exemption per MMGL 12.❑Roof
repairs
insurance requitrA]q c.152,§1(4X and we have no
employees_[No workers' 13.❑Other
cep.insurance required.i
'Azy applaaul dwi chec ks bogy#1 amst also 811 cot the section below showing their wmkere ommpensadon policy infimmmdan.
Homwwnes who submet fdis sflidsw m a mg dtey are doing all wort aad then hire cumille cmuwftus am st subank a new affedwit indicating such.
ZConttKwn fat check this box most attached su additin sheet showing the name of fbee sofa-conuxtn2s and smte whether or not those emities have
employees. If the sab•conuactots bum employees,racy mast pravide ibew wodws'comp.policy number.
I am an employor that is providing workers'compensation insurance for my enipioyees. Below is the policy and Job site
information.
Insurance Company Name:
Policy#or Self-ins.Lie.##: F.xpindion 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 im;xmition 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 certifycinder the pains and penalties ofpedury that the information provided above is bete and correct
Signature: //Pa Date:
Phone
0,,01cial use owddy. Do not write in this area,to be completed by city or town offidgal,
City or Town: Permit/Ucense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Cityfrown Cleric 4.Metrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
6
Town of Barnstable
Building Department
Brian Florence,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
x BARNSTA11I4 •
MASS. www.town.barnstable.ma.us
059.
D UAA'1 A
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION: �1.5 PA; b i a s E D H f A A n n I"s 0,2 N O/
nuinber _I' n (� street village
"HOMEOWNER": QU0114) Ili tt/) r4Lj- 90 ' 'FF/R.5
nart home phone# work phone#
CURRENT MAILING ADDRESS: 1-4 lA qC l e a t s -t1-
,�nNntS t,2Lao/
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.
re ofRomeowner
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
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.
C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\9NNOKXYW\RESIDENTILONLYEXPRESS.doc
09/26/17
FC03 la- 1 -17
,r/ . Town of Barnstable RECEIPT
200 Main Street. Hyannis MA 02601 508-862-4038
Application for wilding Permit
Application No: TB-17-4065 Date Recieved: 11/22/2017
Job Location: 102 WINDSHORE DRIVE, HYANNIS
Permit For: Building- Insulation - Residential
Contractor's Name: WILLIAM J MCCLUSKEY State Lic. No: CSSL-102776
Address: , West Yarmouth, MA 02673 Applicant Phone: (508) 398-0398
(Home)Owner's Name: MCKAY, WILLIAM H & WENDY D Phone: (508)771-4802
(Home)Owner's Address: 102 WINDSHORE DRIVE , HYANNIS, MA 02601
Work Description: Add R-38 cellulose to the attic. Add R-19 fiberglass to the basement box sill. AiK'seal the attic plancHand
basement with expanding foam. General weatherization.
.Q
11
03
Total Value Of Work To Be Performed: $4,700.00
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 wort: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
tiling 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: William McCluskey 11/22/2017 (508)398-0398
Applicant Date Telephone No.
Estimated Construction Costs/ Permit Fees
Total Project Cost : $4,700.00 Date Paid I Amount Paid Check#or CC# Pay Type
ITotaI Permit Fee: $85.00 11/22/2017 t $35.00 XXXX-XXXX-XXXX , Credit Card
0299
jTotal Perin it Fee Paid: $85.00 11/22/2017 ( $50.00 XXXX-XXXX-XXXX r credit Card
- ---- -
i 0299
T111IS IS NOT A PERMIT .
yi
oFtMME r�
Town of Barnstable *Permit# � �
&t Expires 6 months rom issue date
Regulatory Services Fee
• anaxsTABM
v� 1639. � Richard V.Scali,Interim Director
ArfD�,tp
Building Division
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Map/parcel Number _
V Not Valid without Red X-Press Imprint
Property Address 45 P ; i 'i p,S 46A 0U Cam �)y) _!s fig O a lop
esidential Value of Work$ Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address 1 004n
14 u(Icl - A1S upau LLia�5 MA 02LI nI
Contractor's Name AOIA Telephone Number
Home Improvement Contractor License#(if applicable) ( Email:
Construction Supervisor's License#(if applicable)_��/T �_IM02 me um oir
❑Workman's Compensation Insurance
Check one: SEf 16 2014
ElI am a sole proprietor
the Homeowner TOWN OF BARNSTABLE
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Reque t(check box)
[ e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Yur✓rtOtA lfl Tr`G,HS
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
®side
placement Windows/doors/sliders.U-Value Anderson N Hoo (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
required.
SIGNATURE:
T:\KEVFN—D\Building Changes\EXPRESS PERMMEXPRESS.doc
Revised 061313
The Commontvealthr of Massachusetts
. Department of Industrial Accidents
r t�,f re of Investigations
m 600 WashingtonStreet
F, Boston BostonJVA 02111
F
n-,rinr?.iPraass.gmIrlia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print IAybly
Name a &o ym tianrle zduai): Avg c4 uSA-i�) f)C."ttF.)
IQ
Address:
City/State/Zip: l Phone#:. `�y-o'Z o�S- � R5
Are you an employer? eck the appropriate box: Type of project(required):
1_❑ I am a employes with 4. ❑ I am a general contractor and I 6. ❑New construction.
employ (full and/or part-time).* havehirers the sub--contsactms
2_❑ I am a sole proprietor or partner- listed on the attached sheet- 7- ❑Remodeling
strip and have no employees These sub-contractors have S. ❑Demolition
w for me in an capacity-- employees and have workers'
working y t 9_ ❑Building addition
[Na workers'camp.insurance comp.insurance,,
Vqufired.] 5.❑ W.e are,a corporation;and its 10_0 Electrical repairs or additions.
3.Fk i am a,homeowner doing all work. officers have exercised their I LFI Plumbing repairs or additions
myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs
insurance required.] c.152,§1(4),and we have no.
employees_[No workers' 13-❑Other
comp-insurance required-]
'Any appttcanr that checks box#I arcat also fill out the.section below showing their wwkers`compensation policy,in:format on-
I Kmneziwners who submit this affidavit im&catimg they are doing all work a"then hire outside contractors mug submit a new affd2wit indicating said
tConlrwtors din check tlus box artist attached an additional skeet showing the t>mne of the sn comttarctors and state whether or not those entities lizve
employees. If the sob-contractors have employees,they must provide their worker®'comp.policy number.
I aaat an amp gs'Or that is proildirtg trParhers'cogmfisation insurance for any earrpiayees. Below is the polio and Job site
information.
Insurance Company Name:
Policy 4 or Self-ins.Lie.#: Expiration Date:
Job Site Address: CitylStatelzip:
Attach a copy of the workers'compensation policy declaration page(showing the police number and expiration date).
Failuree 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.GD an&lor one-year imprisonment,as well as civil penalties in the form of a STOP WORK:ORDER and a fine
of up to S250_DD a day against the violator_ Be advised that a copy of this statement may be forwarded to the Office of
lirvestigations of the D:IA for insurance coverageurerification.
I do herebt,certift sander the its andpenahies ofpeduty Meat the infonnation.prot ded abo re is true and correct
S e Z4Date: - I S 0 1
Phone 9- '4 7 q- d --Rf&57
Offirial use only. Do,not write in this axea,to be completed by city or Limn official.
City or Toum: PermitUcense#
Issuing,Authority(circle one):
1.Board of Health 2.Budding Department 3.City/Tonm Clerk 4.Electrical Inspector 5.Plumbing Infector
6.Other
Contact Person: Phone#-.
6
0
Town of Barnstable
Regulatory Services
Richard V.Scali,Interim Director
Building Division
BARNSTABLE. ' Tom Perry,Building Commissioner
y MASS.
1639• 200 Main Street, Hyannis,MA 02601
RFD MAr www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
DATE: G-15 !� Please Print
' �cO�� I
JOB LOCATION: f-p k i �"p S 200ej gu oun n
number street village
"HOMEOWNER": LAt)SA_o ykS5 namet, home phone# work phone#
CURRENT MAILING ADDRESS: 11_ urc l e Iw^n 1 S W ek U
flgCknfl,NS Mc�, GCIloO)
cit 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 re Liirements a /she will comply with said procedures and requirements.
/atur_eot`416'meowno�__�'* �
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. Vou may care t amend and adopt such a form/certification for use in
your community.
T:\KEVIN D\Building Changes\EXPRESS PERMIT\EXPRESS.doc
Revised 061313
P3
COMMISSIONERS DEED
PROPERTY ADDRESS: 45 Phillips Road, Hyannis, MA
I, JEFFERY JOHNSON, Commissioner appointed in the matter of Estate of Kim D. Brazelton
vs. the Estate of Christopher Austin by the power conferred in Barnstable County Probate
Docket No. BA13EO028PP in consideration paid in full of Ninety Nine Thousand and 00/100
($99,000.00) dollars
Grant to AUGUSTO C. NETTO Individually, of 17 Uncle Al's Way, Hyannis, MA, 02601
With such covenants as a court appointed commissioner may give
The land with the buildings thereon located in Barnstable (Hyannis), Barnstable County,
Massachusetts and being further bounded and described as follows:
NORTHEASTERLY by Phillips Road, as shown on hereinafter mentioned plan, one
hundred ten (110) feet, more or less;
SOUTHEASTERLY by land of Lewis P. Paradia as shown on said plan, one hundred
sixty-nine (169) feet, more or less;
SOUTHWESTERLY Lot 32, a shown on said plan, one hundred ten (110) feet; and
NORTHWESTERLY a portion of Lot 30 and by lot 29, as shown on said plan, one
hundred seventy-five (175) feet, more or less.
Containing 18,810 square feet of land, more or less, and being shown as Lot 31 on a plan
entitled: "Subdivision Plan of Land—Hyannis, Barnstable, Mass. Veda F. Mitchell, scale 1 inch
= 80 feet, November 1946, Whitney& Bassett, Architects &Engineers, Hyannis, Mass."which
said plan is duly filed in Barnstable County Registry of Deeds in Plan Book 76, Page 25.
Together with the right of way in common with all others now or hereinafter entitled thereto,
over the streets and ways as shown on said plan, as appurtenant to the above described Lot.
For title see Deed recorded in Book 6781, Page 137.
For authority to execute this deed see my warrant from the Barnstable County Probate, dated
September 2, 2014, Docket No. BA 13E0028PP.
l �
Witness my hand and seal this �� day of September, 2014
,kl;`FF� Y SO ommissione
COMMONWEALTH OF MASSACHUSETTS
Barnstable, ss September �g , 2014.
Then personally appeared before me, the undersigned notary public, the above-named JEFFERY
JOHNSON ❑
o is known by me and to me known to be,
the person whose name is signed on the preceding or aiached document, and acknowledged to
me that he/she/it signed it voluntarily for ' stated pt>irpose.
11 �
Notary Public
My commission expires:
BERNARD T.KILROY
a
Notary Public
COMMONWEALTH OF MASSACHUSETT
My Commission Expires
August 20.2015
Assessor's ma and lot number ....... .�:�.... .. i � C�M MIST
p SEPTIC SY
INSTALLED IN COMPLIANCE
�- WITH ARTICLE II STATE
Sewage Permit number ......// .. ... ... ... ANITARY CODE AND TOINI�
.,
G LATIONS.
TOWN OF BARNS TABLE
Z BARNSTADLE.
D ,•� BUILDING, INSPECTOR
M
APPLICATION FOR PERMIT TO .... :Y....�/ ..........
TYPE OF CONSTRUCTION ............® ....... ce�� ...................................................
1
[✓.... .... ..............I
TO THE INSPECTOR OF BUILDINGS:
The undersigned he eb applies for a per it according to the following-information:
Location .............11. .. . . .. ...... ............ r ..... ..........................................:........:..........................................
ProposedUse ..... Gs...........................................................................................................:.......
ZoningDistrict ............................. . ................... .... ...........Fire District ..............................................................................
.....`. .. .......................Address ......................................................................
Name of Owner��..�....... ....
....................................Address ............................................
Name of Builder .��� .. .. ..............................
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms ..
....
.. ..A
.......................Foundation. .....`�!sC:.... . ....... .................................
................
Exlerior ................ ............................ .......................Roofing .............. .............................. .....................................
Floors ............... .........................................................Interior ............
Heating ..................................................................................Plumbing .................. ..! .........
/ ,�
Fireplace .............................................
................ .....................................Approximate Cost .........................................•....
Definitive Plan Approved by Planning Board ________________________________19_______. Area S
Diagram of Lot and Building with Dimensions Fee ................... ................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
� \
I hereby agree to conform to all the. Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ..
Hebron, MeJvin & Phyllis ^ �
� .
/ .
�AA�2 �
No .�����-.. Permit for ---a��---
family.............................................- --~----.- �' '
.� _ .
lli
Location .I�x�d________.Hya
nis
--------.^��^�x���----.-------..
�
Melvin & Fhyllis Hebron
� Owner ---________............._,...^...........
. .
zraoe
Type of Construction .............................. . \ �
&� `
�
-----..--------------------. . .
�
Plot ............................ Lot ................................ ^
~ '
-
`
'
|
� Permit Granted --. .4--.—.lg 73 .
� *
iInspection
� uo�e o* l |
. �
- - . \
~~'~ Completed . /
' J
` [
� \ �
" 1
�
|
PERMIT REFUSED
~~ .
-----.----------------.. lA
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'--------------------------
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^-----..-------------------- . .~
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.~..-.,---~--------..-.-.-~----.,
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� Approved ................................................. lg
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