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HomeMy WebLinkAbout0136 STARLIGHT DRIVE y e I' i �- a0 � 347 Qf THE T Town Of Bar-4sh ble -I �T o "P.ermit �ARivST,►Bc�, Re l`a.tO > rpires 6 mo' front issu dal ry Services y mass. Fee `b i639 A���. Thomas F.Geiler,Director .orb MAC Building.D vision Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town,barns tab le:ma.us_ Office: 508-862-4038 ' EXPRESS PERMIT APPLYCATYON Fax: 508-790-6230 RESIDENTIAL-ONLY Not Ya!!d wit/rout.Red X--?tees JmpriRt Map/parcel Number Property Address r " rsidential Value of Work inimum fee of$35.00 for work under S6000.00 Owner's Name&Address Contractor's Name Telephone Number������ ���✓� Home Improvement Contractor License#(if applicable) r Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 09/1'have Worker's Compensation Insurance , � it 17 Insurance Company Name _ - SEP 2 6 2017 Workman's Comp.Policy#_��Z�efl,�catemu�st T c p Copy of Insurante Compliancempany each permjt, �p Il �' AD p� Permit Request(check box) V n C Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) L� file-side ❑ Replacement Windows/doordsliders. U-Value #of doors (maximum.44)#of windows f Where required: issuance orthis permit does not exempt compliance with other torn dcpanmeni reduiations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A opy of the H. 10 Improvement Contractors License& Construction.Supeisors Lice,se ired. e is -NATURE: .z—�_ :onstruction Supervisor Home Improvement .icense Number#008267 Contractor Registration#114813 )SHA Approved Member of the Better Business Bureau come Phone#508 420-5131 CELL PHONE#508 280-0802 ESTIMATE JAMES DANFORTH P.O.BOX 973 COTUIT, MA. 02635 ;tephen Whalen L36 Starlite Dr. Vlarstons Mills %ugust 30, 2017 Nork to be completed on both the entire house and garage roofs as follows. -Iouse and shrubs will be covered with tarps while work is in progress. remove existing roofing shingles. :1enail any loose roof sheathing. nstall .032 aluminum drip edge at the roof eaves. Install new aluminum vent pipe flashing. Install grip rite ice and water shield on the bottom edge 3ft. up onto the roof, around vent pipe flashings and up the side of all skylight frames. Install Rhino roofing underlayment over the remaining roof_sheathing from the top of the ice and water shield to the roof ridge. Install a 30-year Architectural type roofing shingle, using CertainTeed Landmark, which are algae resistant shingles. Shingle weight is 240lbs. per square. The standard wind warranty is 1101M.P.H. will use CertainTeed starter shingles along the roof eaves and rakes, will also use CertainTeed shadow ridge for the roof caps, over the ridge vent. This process will increase the wind warranty to 1301M.P.H. . Clean out gutters and clean yard with magnet and the end of the job. This price includes the building permit. There is a limited lifetime manufactures warranty on shingles. will provide a seven year warranty against any roof leaks. Material and labor $7,200.00 All materials are guaranteed to be as specified. All work to be completed in a workmanlike manner according to standards practice. Any alteration or deviation from above specifications involving extra cost will become an extra charge above the estimate. Our workers are fully covered by Workman's Compensation Insurance. DATE OF ACCEPTANCE OME IGNATU CONTRACTOR SIGNATURE �� w TRA rELERS J WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6HUB-4861 P48-8-16) RENEWAL OF (CHUB-4861P48-8-15) INSURER: THE TRAVELERS INDEMNITY COMPANY OF AMERICA NCCI CO CODE: 13439 1. INSURED: PRODUCER: DANFORTH, JAMES DBA PAUL PETERS AGENCY INC JAMES DANFORTH REMODELING 680 FALMOUTH ROAD PO BOX 973 MASHPEf MA 02649 COTUIT MA 02635 Insured is AN INDIVIDUAL Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 09-29-16 to 09-29-17 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part,One of;the policy applies-to the Workers Compensation Law of the state(e)°listed here: MA as m m� B. EMPLOYE AS LIABILITY INSURANCE: Part Two of.the:poiicy applies-to work in each state listed in item 3.A. The limits of our liAl llity under Part Two are: Bodily Injury by Accident: $ 100000 Each-Accident Bodily Intury.by.Disease: . $ 500000 'Policy�L-imit t o Bodily Injury by Disease.- 100000 Each Employee C. OTHER STATES INSUAANCE::Part Three of the;policy appi es.to.the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06B. D. This policy lneludes these endors®ments and schedules: SEE LISTING.OV ENDORSE.MENTS - EXTENSION OF INFO PAGE, �=r ate.: 4. The premium for this will be determined by our.Manuals'of Rotes, Classifiications, Rates and Rating Plans. All required:Wormation is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: i O=O.1 fs:. WC ST ASSIGN: MA i Rfe GgM1110"wewealth of Massachusetts ' Depart>tzent of.n&isaial Accidews O,lace of luvestia ateora s 600 Washirigto",SiFeet - Bostotr,,MA 02111 �a fvnnv #as&gov1dia N%rorlters' Compensation Insurance Affidax-it: Buflders!Contrac.tor s1Ele icians(Plumbers Alp cant m3 ion Please Print Ledo ly Natue(B,ufflzmIO Vm=tiov idua(): Address: � 9 C itytStat&Ztp: ��IL5I2� Are yop4n employer?Check:the appropriate bon: Type of project(required): i. I am a employer with 1 4- ❑ I am a general contractor and 1 6- ❑New construction employees(full andlor part-time)-* have hired the sub-contractors 7_ Remodeling 2_El am ship and have no employees a sole proprietor fisted on the attached sheet. �partner- These sub--contractom have g. Demolition ship yees ��1oy-c-es and have�zsfKer�' working for ate in any capacity. 9. ❑Building addition [No rlorlceas'cep_ in.:t;ranca�insurance camp. 10"0 Electrical repair:,or additions required.] 5" Q We are a corporation and its 3_❑ I atn.a homeowner doing an work offers have exercised their I i_[]Plumbing repairs or additions �e1£ o worker,°'coin. right.of ex ti=per MOL l2�f repairs ]1 c. 152,§l(, ),and we have no insurance required empt© e o workers' 13.0Other comp_insurance required.] 4,Any a;sphcm dot checks box 01 mast aLo Sll G=the Fection belats sL°Or"iug Max vrorkess'Ctg�iZ EEMtLon policy iaforze3taoa I HaMaeoi*uss who submit t?.iis afRdr,,k iadicstm§thnv are ?nine ail share and then L-a-e Outside cmttacw_s nm-- sabtrait a iL•ia stf>Tdasit indicate sorb +Cnatractors that ched,dm bmt most stta&ed m- addid ng stet shmins the n me of the sub-ccntr ,=rs and stnse est-ethaT a;not those enddas have employees. If the su�ionuw(m have en*4ies,th brier Pi.. we�k�s'oomp-Policy utnnher_ I am an employer that is pravi Itwrkers'cosiapmadion rtist3�stare f or arry Fuaplr��ess. Below is 13te pr�ct�and job she Information. �f® Insurance Company Name: "/,�y �� policy a or Self-ins.Ic_ Expiration Date: J®b Site Address-.. Xaol6ty/StaWZ.ip:. ___.... Attach a cops of the workere ei�pensation policy declaration gage(showing the policy nun a and expiration date). Failure to sects catnera�e as required under Section 25A of IVIGL c. 152 can lead to the imposition of criminal penalties of a fine up to$17500-00 aa&6r one-year m4msonment,as wetl as civil penalties in the farm of a STOP WORK ORDER aad a 5ne of up to$250.00 a day agaimt the violator. Be advised that a edgy of this statement may be fortrratded to the Office of Im-estigations of the DIA for in-guance co-mrage veriEcation. I do h~bv real art to trins d ttsdfies ofpceply drat the informatiouprovided above is tray a correct v � Si Phone r# official Ise ailr. Be tent ser&in this area,-to be eomp8e#e;#.(?a'c@t}'or to o,�tt fat city or town: Per_=AVIAcense# — issuing Authority(drole one): 1.Board of Health 2.Building Department I CitytTown C.le?k 4:Electrical Inspector 5.Plumbing hLspector 6.Other Phone#: �� a,..aataa4i"Person:. �" e4 Massilctig5etts D�partmenX o{ u�lic:"Saf. Board of'BuMing"Regulatiohs and Stan.dardsbP` • Lice6se:'CS-008267;. ' ;Construction Supervisor r. JAMES D DANFORTH°9"r) PO BOX 973• �r jrc. A 'COTUI f MA,02f 36r ' "t .. .r• .J' -xpiraiiq ; 1 Commissioner r er Aifn�rs.3iBus�a�tsq ~ r Office of,-ons 7t " p� MENT-CON F i1oCTSJR HOME IM 1y1ge k < istratiot� 81� ,' 1s rN. Reg l2017 Inaivttl par. {(• y ,:• tx��ration ; Fri•Au k i ,� :.�,J �ME$ OANFORTFi`,• �r..� � ;'•��. 1 4i+ ." . � pki'j,P.OST,RD� lUnd - • u�f• }'�1.1 yn ' l' �'!'1 ..:.�f i y..f�. .T:.�i'rc.¢ r I i i onst�u.ction Sfipervisof Restricted to., • 'lUesse. iicted Building ofayuse o - than $5,000 cubic n Ycitai i; feet.{991 cubic meters)o '.":' endosed space... Failure to Possessa current edition.of the Massachusetts.: State Building Code.is cause for revocation of, this license BPS Lidensing information visit: WWW.MASSAO.v'D ** f�.. .a ._. __... .. .. a. _ .... ., •c •0 i sc uh �t�gistrai�or�aVal�dfor 3odi���rljj e Y hme�,t e��xp�rat�0 ata 4k.$+foundjreturir�f� soi[ onsumeirA$�irs fid)BusItle e rk;plPza Supte 1E �' on1A-l)Z116 3•�.r -.+Z' .I .b t. Sifts Y' F i a otvalid` uf's�Qna Y"� eL ,e E TOWN OF BARNSTABLE Permit No. ................ BUILDING DEPARTMENT ' I TOWN OFFICE BUILDING Cash .......... HYANNIS,MASS.02601 Bond .......:�.. CERTIFICATE OF USE AND OCCUPANCY Issued to CANMETT BUILDERS Address lot il6u 136 Starlight i)ri % zra USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .......................... . 19................. ........................................... Building Inspector ���.,�� '�•,� TOWN OF BARNSTABLE BUILDING DEPARTMENT . sDAA3lT i i ,TOWN OFFICE BUILDING �g out HYANNIS, MASS. 02601 MEMO TO: Town Clerk Olin FROM: Building Department ' DATE: An Occupancy Permit has been issued for the building authorized by Building Permit $k.» ^ ..........................................................»...... Of issued to ..._._... �...... ._. »... . ».. »._.....» . ......__. ............................. Please release the performance bond. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) m A I / L DATA BUILDING TOWN OF BARNSTABLE, MASSACHUSETTS A59c:-49 PERMIT JOB WEATHER CARD -i DATE 19 PERrIT NO. APPLICANT ADDRESS L'iliftYfiti.t t �1j11UC rfi :O\': i J l�cirLaoIt iljlo_"L I+(it, .,i. :! _ IND.) (STREET) (CONTR'S LICENSE) Bu 11d Dwe1 iI.y! ]. �•i.A?.e'�1✓r, I.}.V Dwe 11..ro, NUMBER OF PERMIT TO (_) STORY `� DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) l..0 f: Ut), lib .O t.Liri lei:L !/Y.1.SIC, z�sLoa<: ::i.�.l`; ZONING } AT (LOCATION) DISTRICT IN0.) (STREET) BETWEEN rl...� AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE 7 .......�8U\tG ING iIS TOYBE,.- - ,F,T-_W_I.DE_BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CON STRUCTiOt• TO TYPE uUSE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) 4";':, 1 REMARKS: t�:iliac AREA OR A54�F :;Cl.��L�r: ..•.�,— 4J,uiJt).Ul} PERMIT 6).55t' VOLUME ESTIMATED COST � FEE (CUB,IG/§O UARE FEET) • OWNERi� ^:y�_ BUILDING DEPT. ADDRESS BY j ;` •1 THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THE' EOFj EITHER TEMPORARILY OF 4PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER TH 'BUILDING CODE, }BUST BE AP 111'. PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEC FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITION: OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 ICU HEATING INSPECTING APPROVALS RE IMAnM I C T11 FTU L5 i 1 IN -HER- 2 ---7776 *t+C-.K :,AL_ NCT 'P')=EFD UNT:1- Tip= PERMIT ''W!LL BECOME NULL AND VOID IF CONSTRUCTION iNSFECTIONS iNDICATED ON TH!S CAR:NSPECT F -!AS �PPPCVEJ -vE: vas C S WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE STAGES JF ONS;t';uC'.i?N' PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION. r S1 r =L-ow //o X 3 = 33o I?c" /S.L/ s. >C z 27 f �. 7-07 41- GCS/�! i DES/�/ PE L4T/tx/ �.4�L C - A.A-16 (D OFPETER SULLIVAN i l - No. 29733 h 3 f�. . 6AXT R . . C�>. . (` _ ss�Q,V:A L f l��\: ' AeeAE p. �oi5 44 ( f<" oisr. � E sZ /GNU /.f/� BOX 9Z_� SEarrG PLOT el-5'"Al 1 rclL�1 TE ,• '� �L.d�/EL f�L.Q.V .�E�E,eE.VcE /o 8C c1 7 l�Lo WA- Eff- / LE2T/,CY 7-1 1.47 T•�,�E' �4it/1>.fETl�/JG,� .2�4V/,eEisrl�NTS o� T114 ,2EGisr�.eEl GQ.�o.SU.2vEyo,P�S AV Locdr�,a W/Ts,�iN T,�✓E �L�oPL..4iiCi �.-.� rlt ; t T/1!s fit.e v /.s �oT I�•4SE0 aA✓.4IV/iY_ST,2- - -- Shf�lyit/,yE,e.�.JN S,�v�nt/G 1J A&7 QE USEp cy �..... E��6C �� TEM MUST BE Assessor's map and lot number ..........e i~` .. pN r INSTALLED IN CO MPL�P�Y®CE i THE tp�y Sewage Permit number .......... �G?.-.u�. . .........: V14ITI�1 TITLE 5 'NVIRONMENTAL CODE AND 't EABBSTODLE, House number ...................................�...e ...... �' TOWN REGU IL,Q��'IOI'9S o00�06 v a e0� r w ` TOWN OF BARNSTABLE BUILDING . INSPECTOR APPLICATION FOR PERMIT TO �► -ti �lA/?4.... 'Y7.h'1`:!�.................................................. .............:.......................... .. TYPE OF CONSTRUCTION ............ ..6 01�..... ........................................................................... ...� Q:�..� J.................19..0..t r 1 TO THE INSPECTOR OF BUILDINGS: 1 The undersigned hereby applies for a permit according to the following information: Location .......�.4.�'..�a.�v......�T.H 2.L.I.�a. ........�. �� ....y. ProposedUse ......... .1.�?.��.�. -.... N!!n.1.�.,�1...... 0 I?...` ................................................................................................ Zoning District .............................................Fire District ........1.....0 Name of Owner ......C..Vps.►?'?.n..G.T...�!- A. rt&,. 4:...Address —72., .t 1.6o tm.R.''176U,r1 Name of Builder ................. .........:...............Address ........... Nameof Architect ..................................................................Address ........................ ........................................................... Number of Rooms `r .'..............................................Foundation ...... li. ��?.:.. .Ssht�. GT`{.............. Exterior ............ .. M<...........................Roofing ..........M' .pl?4& . ....................................... Floors ...................1.,,,i9 .P..fir. ........................................Interior ...... r.14-77—G ............................. .............. Heating .!°'5...��t1`........ ...........Pl .: .umbing ...... .�'r .................................................. Fireplace ......... .. 5..............................................................Approximate. Cost......• `QY:9.................../......................... Definitive Plan Approved by Planning Board -----------_------_-----------19_______ . Area ....... 1............ Diagram of Lot and Building with Dimensions Fee ................ : V.-[.' � ... ..... . . ... ............ ....... SUBJECT TO APPROVAL OF BOARD OF HEALTH 0 O G LjDO Fr. �I � V Ll S Fr G i O L,oT� � 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS k I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. _ D % ' Name ...... .. .Y........ .. ............................ Construction Supervisor's License .......... .. c.CAMETT BUILDERS 0128865.... Permit for ....................................One e St a r y Single Family Dwelling ...............­­............................................ Location .......Lot...6.6........1.3.6...S.t.ar.' ight Drive . . . . . .. . . .. . ................... Marstons Mills ............................................................................... Owner ....Camme...t.t...Bui.l.d.e.rs........................... .......... . Type of Construction .........Frame ................................. ............................................................................... Plot ............................ Lot ................................ January 22, 86 ...........................Permit Granted .... ..........-.19 'Date of Inspection A-:7/2 ..........19 -Date Completed ..19 gg -a ItV, Town of Barnstable *Permit#�-� Expires 6 months from issue date °Y Regulatory Services Fee a snxNAM E M"�'1639. Richard V.Scali,Director U �� Building Divisioq o �q Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 JUN 2 www.town.bamstable. a.us Ill 7 2D16 Office: 508-862-4038 11VA1 (�� 8/4 .���1 , j_ Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL�0N&iV Not Valid without Red X-Press Imprint Map/parcel Number Property Address /3�c )29, 919 37d-1v S JW11,5 ❑Residential Value of Work$ 7— 70© Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 5_ =1-.e ST!k9�1�i,47— DP_ Contractor's Name—��� Gt �f�E,K! Telephone Nu tuber tSDB 3�v5�-87 3 Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) S O l`6 9 72. ❑Workman's Compensation Insurance Check one: I am a sole proprietor I am 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 Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ,Replacement Windows/doors/sliders.U-Value (maximum.32)#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: C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 i The Coninzonwealth of Massachusetts Department of Industrial Accidents Office.of Investigations 600 Washington Street _ Boston,MA 02111 ivmn mass gov/dia Workers' Compensation Insurance Affidavit-Builders/Contractors/Elech-icians/Plumbers Applicant Information Please Print Letibly Name(Basmess/o�aon/Individual): T� � L.o� . (City/_StateLZi�: S Doti �l5 oZGYy Phone 9- rho-r Are you an employer?Check the appropriate box: T of project(required): 1,.❑ I am a employer with 4. ❑ I am a general contractor and I Type e 7 ( e4 �= 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 Mess,sub-contractors have S. ❑Demolition have worms' working forme in any capacity. employees and.h I 9. ❑Building addition [No workers'comp.insurance coup.��D� required-] 5. ❑ We are a corporation and its ME]Electrical repairs or additions officers have exercised their 11. Plumbing repairs or additions 3�I,am a homeowner doing all work ❑ g p myself o workers' right of exemption per MGL m3` (N romp- 12.❑Roof repairs insurance required.]l c.152,§1(41 and we have.no / employees.[No workers' 13CRIOther /X•rVS � comp-insurance required_] •Any applicant that chec ks boa#1 maw also fill oat the section below showing their workers'compensation policy information- 1 Homeowners who submit this affidavit indicating they are doing all waak and then hire outside contractors nmst submit a new aff davit indicating such. -Contr ctors that check this box Est attached as additions!sheet showing the name of the sub-contractors and slam whew or not those entities have employees. If the sub-contractors Lace employees,they mast pmide their workers'comp.policy number. I am an employer that is providing workers'cortgm cation insurance for ray employees. Below is Ste policy and job site informatign. Insurance Company Name- Policy#or Self-ins.Uc.ip 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 W forwarded to the Office:of Investigations of the DIA for insurance coverage verification. I do hereby eerhj6y under thepains and penalties of peditry that the inforination provided above is Gate and correct. Date: G -Z -/ Official use only. Do not ivrite in this area,to be completed by city or town o ficiaL City or Town: PermitlUcense It Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Regulatory Services �f►IE Richard V.Scali,Director Building Division eatsrtsl'Aam ' Tom Perry,Building Commissioner � 16f�Q. `0� 200 Main Street, Hyannis,MA 02601 o �s www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE:..__. JOB LOCATION: ST � nnu�um/ber street village "HOMEOWNER":_ 5Xep/ q(/'�7/��f r6g-361�F7V' name home phone# work phone# C W NT...MAIL_ING ADDRESS: 16& 33;5 R su s J-/,�1s 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 poriod 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 /she will comply with said procedures and requirements. �S re of Homeowner 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. You may care t amend and adopt such a form/certification for use in your community. C:\Users\DecollikWppData\Local\MicrosoftlWindows\Temporary Internet Files\Content.Oudook\2PIOIDHR\EXPRESS.doc Revised 040215 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel l Application Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Uk Date Definitive Plan Approved by Planning Boards Historic - OKH _ Preservation / Hyannis r Project Street Address V1. Village Owner ! nkaL . Address S%r►-, Telephone 737-7q 7-7 Permit Request v el fi't^7} +- i�� ce_li?,,-t h �1-k Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family GY Two Family ❑ Multi-Family (# units) ;_, --I C SR o Age of Existing Structure Historic House: ❑Yes ❑ No On Old King ighway.Ll Yew ❑ No 71 Basement Type: ElFull ❑ Crawl ❑Walkout ❑ Other `-) Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) U Number of Baths: Full: existing new Half: existing new .. w Number of Bedrooms: existing _new — rn u 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 (BUILDER OR HOMEOWNER) Name bike McCarthy Construction Telephone Number PO Box 52 Address Wpct Dennis. MA 02670 License # Cell (508) 280-6964 r;S1,_48633 141[C'_-169393 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 19 SIGNATURE DATE I--hr •� FOR OFFICIAL USE ONLY APPLICATION# DATE•ISSUED f MAR/PARCEL NO. • ADDRESS. VILLAGE ' OWNER .. 4. DATE OF INSPECTION: w `} FOUNDATION ' s FRAME INSULATION., A FIREPLACE' k ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL !t GAS: ROUGH FINAL j FINAL B.UILDIN,G: t ' f , DATE,C,LOSED.OUT i t ASSOCIATION. PLAN NO.- t pt`t S ,S 7 ti Town .of Barnstable ReO ory Services • RAMCIM "RKAM • Manm*v.sca14 Rector 0 ,uas� Bwldiiiag Diddon Tom Perry,Bnild6ng Coxwob loner 200 Main St eet,Hya uk'MA 02601 wwwtowa.barastable ma as Office: 508-862-4038 Fax: .508-790-6230 Property Owner Must Complete--:mod.Sign This *e'Uiou .__ ._... .. ..__.... . .... _ _ ..---._... If JUsimt��A Builder --------- •-- ------ - - - _. _.. IluVI Lt-'V ,:as Owner-offfie:56'ject pigpeny hereb authorize .Lc- 4L C �ATI - to:act:off:ray behalf, p:auth . in all mauers relative to.work autho ' this budding permit application for. l3is Sete ► �� -Dn�t MNHS rtrn.S K'� IlS MA bZ Ad , "Pool fences and alarms are the respons11y'of:tie:app3zcanc:Pools are-not to be:fiIled:or',', lined•before-•fence:is installed;and all final. inspections are performed and accepted. a Slept on Whalen(Nov 20.2014) Signature of Owner S*aat=--..ofApPfic aut Priat Naine Print.Name Date QTORMS:owtUERMWONPOOLS Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-058633 MICHAEL J MCC,;AR PO BOX 52 ' W DENNIS MA 11264 y , \A 5�14_ Expiration Commissioner 04/10/2016 Of-ice of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 169393 Type: Individual Expiration: 6/16/2015 Tr# 238121 •MICHAEL MCCARTHY MICHAEL MCCARTHY - -- P.O. BOX 52 --- WEST DENNIS MA 02670 ---- Update Address and return-card.Mark reason for change. SCA 1 fi 20M-05/11 Address Renewal ❑ ❑Employment Lost Card �..`/ The Commonwealth of Massachusetts Department oflndustrialAccidents Office Of Investigations 600 Washington Street Boston,Mgt 02111 w omnass gov/dia Workers' Compensation Insurance Affidavit: Builders/Confractors/Eiecfricians/Plumbers `. Applicant Information Please Print Le ' I Mike McCarthy Construction Name(Business/Organization/Irm ividual):_ PO Box 52 Address: West Dennis, MA 02670 City/State/Zip: CS1pht§Q3 HIC-169393 Are yxu an employer?Cheek the appropriate box: Type of project(required): 1. l:am a employer with 1 4. ❑ 1 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 propridtor or partner- listed on the attached sheet t 7. []Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity, wotieers'comp,insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL I LE]Plumbing repairs or additions myself.[No workers comp. c.1.52,¢1(4),'and we have no 12.❑R If repairs insurance required.]fi employees.[No workers' comp.insurance required.] 13. ther *My applicant that checks box A must also fill out the section blow showing their workers'compensation policy information. t Homeowners wdro submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new affidavit indicating such. tContractots that check this box must attached an additional shett showing the name of the subcontractors and their workers'comp.policy lyd rmation. lam rm employer Mat Is providing rporkers'compensatlon Insurance for my employees Beldip Is Cite policy rind job site Informadotr. Insurance Company Name: SIT / 1A-j Policy#or Self-ins.Lin#: V WC. lao-(�o t 1(, " _')o il.4 Expiration Date: Job Site Address: 13 C City/State/Zip: t 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 ofMGL 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 I Investigations of the DIA for insurance coverage verification. I do hereby cer7tfy r! a pa a maltks of perjury that the information provided above is true and correct. Si ature: Date: Phone P Ojj7ctal use only. Do not write in this area,to be completed by city or town ofj'klaL ti City or Town: Permit/Llcense# 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#: TE(MM/DDNYYY) ACORV CERTIFICATE OF LIABILITY INSURANCE °A07110/2014 `� 07/10/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER 01962-001 NRO€ACT Bryden&Sullivan Ins Agcy of Dennis Inc ��? ,.Et): (508)398-6060 1 Am.No,: (508)394-2267 PO Box 1497 �S{Ess: So Dennis,MA 02660 INSURER(S)AFFORDING COVERAGE _NAIC 0 INSURER A• A.I.M.Mutual Insurance Company _ _ _ 26158 INSURED INSURER B: Michael McCarthy Construction Inc INSURER P O Box 52 INSURER D: West Dennis,MA 02670 INSURER E COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NG i WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 'A1-IICH 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 BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE I we POLICY NUMBER Auger MA LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PR I occurrence) CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ ENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1POLICY �EC ��OC AUTOMOBILE LIABILITY COE aMBINEDccidentS INGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED F- SCHEDULED BODILY INJURY(Per accident) $AUTOS — HIRED AUTOS NON-OWNEDPPROPERT DAMAGEAUTOS -( $ _— $ —- UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED I I RETENTION $ $ NNIAWNFROX /N X 1� A AONYICROPRIGQWPAQT(ySF3/�1tECUTIVE1 N/A VWC-100-6017656-2014A 7/17/2014 7/17/2015 E.L.EACH ACCIDENT $ 500,000.00 (Mandatory IEIn�N�Httdt)Rc�(uu���luu ttiuntt E.L.DISEASE-EA EMPLOYEE $ 500,000.00 69TCA N OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Workers Compensation Coverage applies to MA employees only. CERTIFICATE HOLDER CANCELLATION Thielsch Engineering 195 Francis Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cranston,RI 02910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 2( °Ft , Town of Barnstable . ° Regulatory Services ELAMSr"ASS E'Muss. Thomas F.Geiler,Director B i679. �0'rE019 i Building Division Ralph Crossen,Building Commissioner 367 Main Street, Hyannis,MA 02601 i o , Office: 508-862-4038 Fax: 508-790-6230 SHED REGISTRATION Location of shed(address) Village .+ AP) 1)I-V Property owner's name Tel hone number /D x / y� Size of Shed Map/Parcel# Signature D A Hyannis Main Street Waterfront Historic District? k Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) • S' o� b PLEASE NOTE: IF YOU ARE WrrEIM THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEETHE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-fortis-shedreg 2 . Xji IL� GQIU�Gc �2i,�/[�LlL X LJ SC /,L-00 �.�15 •sdL PiT'— USA , • /S� 5� x z .� _ . .3g5 2/ LC 21111 IS _ PATERZiF SULLIVAN A. �.X h 1 NO. 29733 � 0 6AX"1,4 ' a ' -�..��........ —71 71 //W E I FG ' ' 71 2 cl��4LGlL &oc, �7� o //V� V/�• ,vv a--AvE ' �.E.2T/F/EO PLOT pL4�✓ �,c%1►T7= z/�— G•�� � / LOG,�IT/O.t/ �'1.�11��J1 ZM/� �%i t_; �2d�/LL yL le__=, let— Li z-- yE.�Eo// GOMPGY.S W/TX�7f�E S/�E�,/�E 6.4X7-ZrC s'it/rE IMe. ,4�t/D.fETl�/�G,e ,2E4V/2EklENrS o� Ti'/� .2EGiXl255 D. dNo.Se-l,eYEyo,E /E,'2Y�LLc LoC.�rE.v W/Thy14" T.�E �YaovPG.Q/�/. "' T IrU�L..iC.-c �e ' / { +�J , T/1!t P��v /s Ala7 a.4sEo o�v,a.v iiYs. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) V A�((,D I DATA r yy_ ` Assessor's map and lot number .............r....................;........ �oF THE To Sewage Permit number .............:............... ......... 3 Z BARNST�LE, i Housenumber ........................................................................ �o O 1639• E MPX TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........................tti C� C e � ! .!?.`..... :1'::.!?i::F...................................................... ............... .. TYPEOF CONSTRUCTION '...............................................t..................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .........................................................................::............................................................................................................ ProposedUse ................. .......:......... ......... . ................'...:................................................................................................... Zoning District ..................................................Fire District .........'....... Nameof Owner ............... ................................................:.....Address ........................................................................................ Nameof Builder ....................................................................Address .................................................................................... Name of Architect ......................'............................................Address .................... ................................................................. Numberof Rooms ......................................Foundation :...... ............................................... Exterior J ...Roofing Floors ................ .Interior .......` Heating ..................................................................................Plumbing ......................:........................................................... Fireplace ...........I..:..::..............................................................Approximate Cost .....................:l......................... Definitive Plan Approved by Planning Board ---------------_-__-----------19--------. Area Diagram of Lot and Building with Dimensions Fee J SUBJECT TO APPROVAL OF BOARD OF HEALTH r, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............................. :....... ................................... Construction Supervisor's License ..................................... CAMMETT BUILDERS A=99-49 28865 One Story No ................. Permit for .................................... Single Family Dwelling . ............................................................................... Location ....Lot...66 1.3.6...Starlight...Drive Marstons Mills ............................................................................... Owner .........C.a.mme.t.t...Bu..i..l.......der.s...........I............ .... . Type of Construction .....,Frame......................... . ................................................................................ Plot ........................... Lot ................................ January-, 22, 86 Permit Granted ..................... ..................19 Date of Inspection ....................................19 Date Completed ................r.......................19 (�o