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CENTERVILLE-OSTERVILLE-MARSTONS MILLS
FIRE DEPARTMENT
1875 Falmouth Road
Centerville, MA 02632
508-790-2375 ext. 1 FAX 508-790-2385
June 23, 2017
WURZBURG, FRANCIS
(1_40_WILL'IMANTICDRIVE —�
MARSTONS MILLS,`AW02648
An inspection of your facility on Jun 23, 2017 revealed the violations listed below.
ORDER TO COMPLY: Since these conditions are contrary to M.G.L. Chapter 148 and/or 527 CMR 1, you must correct them
upon receipt of this notice. An inspection to determine compliance with this Notice will be conducted on Jun 23, 2017.
If you fail to comply with this notice before the reinspection date listed, you may be liable for the penalties provided for
by law for such violations.
Violations
MGL 148 SEC 26E Smoke Detectors in Dwelling Units
Note Not tested.
11.8.3.5(5)(6)(7) Smokes min of 36"from fan blades/HVAC/bath
Note Relocate 1st floor hallway photo/CO combo to min of 36" from bathroom door.
Must keep min of 6'from cooktop and maximum of 10'from bedroom doors.
Remove battery operated ion/CO combo.
R314.3 Smoke alarm in each sleep ni g)room
Note Add smoke alarms in each 1 st floor bedroom per plan.
R314.1 Photoelectric smoke alarms `.
Note All smoke alarms must be photoelectric only.
R314.3(4) Smoke alarm near base of stairs
Note Remove battery operated smoke at base of stairs on 1st floor and replace with hardwired interconnected.
11.8.2.2(4)All smoke alarms must be same brand
Note All smoke alarms must be same brand.
I --
Inspection Note Fire alarm plans have approved and permit is ready at 200 Main St.
See building department to clarify building permit status and to modify language per Building Inspector
Ed Bowers.
If you have any questions or concerns please contact Fire Prevention at 508-790-2375 ext. 1
1 -
8310 MICHAEL GROSSMAN NA
Inspector
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m'"E (508)862-4025
4 FAX(508)790-6230
EDWIN BOWERS
BUILDING INSPECTOR
TOWN OF BARNSTABLE
REGULATORY SERVICES
BUILDING DIVISION
TOWN OFFICE BUILDING
200 MAIN STREET,HYANNIS,MA 02601
email:edwin.bowers@town.barnstable.ma.us
508-790-2375
Michael Grossman
Fire Prevention Officer
Fire Investigation
CENTERVILLE-OSTERVILLE
MARSTONS MILLS FIRE&RESCUE i
1875 Route 28 `
Centerville,MA 02632
mgrossman@commfiredistrict.com
NOTES RECEIPT E '� 1,7 No. 7 6 7 913
RECEIVED FROM I I U 0 vv� <<►rV`-�V 6
ADDRESS
FOR
ACCOUNT HOW PAID
AMT.OF
COUNTa5
CASH
AMT.
PAID CHECK (\ V
BALANCE MONEY BY v T�r
DUE ORDER
02001 R-EgeM ID 81.808
w 4Application for Oeview ❑Permit to Install Fire Protection System
�To: Head oftheyFire Department
i Application is hereby made in accordance with the provisions of Chapter 148,and regulations made under authority thereof
to install for the person or persons and at the location named herein, certain equipment for a fire protection system. This
i application is made with full knowledge of the current requirements of the regulations governing such installation, which
will be made in compliance therewith. The installation of said system shall conform to plans presented for review by the
Tire Department having jurisdiction.
Permit No.
PROPERTY INFORMATION
ZI
Property Address: / /w �J/LL 1 A ti A,-)I c- ., Map: Parcel:
_tr.
Fire District: ❑ Barnstable COMM ❑ Cotuit ❑ Hyannis ❑ West Barnstable Use Group:
Name: /C� L3 4 z- V CX �` ❑ Owner ❑ Build
Address: ��^�i Phone:
FIRE PROTECTION INFORMATION
Check One: ❑ New System ❑ Repair/Update to Existing System XRequired Upgrade to Current Code
Fire Alarm System: ❑ no Volt ❑ Low Voltage ❑ Carbon Monoxide
Sprinkler System: ❑ Wet System ❑ Dry System ❑ Combination ❑ Underground Fire Service Main
Hood/Suppression System: ❑
Other: ❑
to c
INSTALLER INFORMATION q j
Installer Name: r'
Mailing Address: r .,!'/, e
City, State and Zip Code: Phone:
Certification#:. ❑ Class A ❑Class B ❑Class C ❑Class D Expires:
r IC t V A.
Inspection Contact Name and Phone(s):
` OFFICE USE ONLY
Application Date: GAH M Taken by: Permit/Applic. Rec'd: #Plans Rec'd:�
Plans reviewed by: s f1Y_ Date: ❑ Approved ❑ Incomplete
Comments: '�A tip -'J R r, �
I have inspected the above installation and found it to be I have provided accurate information for the above
in accordance with the information and plans provided application and will install this system in accordance with
with this application. applicable laws and regulations.
FIRE DEPARTMENT DATE SSIIGNATURE yA DATE
SEE REVERSE SIDE FOR INSTALLATION/INSPECTION CHECKLIST l lRiaJ1 + F� �/'i.)yYL-ze� �, d J ��0(g�
PRINT NAME PHONE#
WHITE-FD ORIGINAL YELLOW-INSTALLER
Barnstable C.O.M.M. Cotuit Hyannis West Barnstable
~ .508-362-3312 Phone 508-790-2375 Phone 508-428-2210 Phone 508-775-1300 Phone 508-362-3W Phone
508-362-8444 Fax 508-790-2385 Fax 5o8-428-0202 Fax 5o8-778-6448 Fax 5o8-362-3683 Fax
FIRE ALARM INSTALLATION &INSPECTION CHECKLIST ,
Note: All installations shall conform with 78o CMR 8`h Edition (MA State Amendments), 2009 IRC'R314 & R315 and
maintained in accordance with R3i4&R 315, manufacturers instructions and listing criteria and otherwise shall be installed
and maintained in accordance with Chapter u of NFPA 72 2007 and 527 CMR 12.00. This checklist is based on typical
installations only. If and when unusual or special installation circumstances are presented, consult the fire department.
❑ All smoke alarms shall be photoelectric type ❑ Upgrade: Entire building has been upgraded to
listed in accordance with UL217 or UL268. ((R314.1 IRC current code with addition or creation of one or more
and MA Amendments) sleeping rooms, or if dwelling undergoes complete
reconstruction. (AJ102.3 MA Amendments)
❑ In no cases shall more than 18 initiating devices
be interconnected (of which 12 can be smoke alarms) ❑ Detectors mounted on walls shall be no more
where the interconnecting is not supervised. (u.8.2.2(2) than 12"but no less than 4"from ceiling or adjoining wall.
NFPA 72) (u.8.3.4 NFPA 72)
❑ AC primary(main) power shall be supplied either ❑ Detectors mounted on a ceiling shall not be
from a dedicated branch circuit or the un-switched closer than 4" from wall. Recommended: mount
portion of a branch circuit also used for power and detectors 2-3 feet from wall. (u.8.3.i NFPA 72)
lighting. (u.6.3(4)NFPA 72)
❑ Detectors not closer than three (3) feet from
❑ The secondary power source shall be supervised paddle fans, supply vent for HVAC units, and bathroom
and shall cause a distinctive audible or visible trouble doors,measured horizontally. (11.8.3.5(5)(6)(7)NFPA 72)
signal upon removal or disconnection of a battery or a
low battery condition. (u.64i)NFPA 72) ❑ Fuse panel clearly marked to determine
compliance with(n.6.3(4)NFPA 72)
❑ Activation: Activiation of one detector causes the
alarm in all required smoke detectors in the unit/dwelling ❑ Detectors shall not be located in "dead air"
to sound. (R314.3 IRC) spaces, shall be mounted on slope of peaked ceilings
within three (3) feet of highest point, not on sidewall. If
❑ Signal intensity:Required alarm sounding devices ceiling at peak is flat, detector shall be mounted on this
shall be 75 dBA at pillow level. (11.3.6 NFPA 72) surface. (u.8.3.3 NFPA 72)
❑ Required Locations (R314.3 IRC and MA ❑ Heat detectors required in attached garages or
Amendments) internal garage and interconnected with household fire
1. In each sleeping room warning system. (R314.5 MA Amendments)
2. Outside each separate sleeping area in the
immediate vicinity of the bedrooms. (Within ❑ Installation of listed 120 volt or low voltage
21' of any door to a sleeping room, the carbon monoxide detectors. (R315 IRC, MA Amendments,
distance measured along a path of travel. and 527 CMR 31.oo)
(11.5.1.1(2)NFPA 72) 1. On each story of a dwelling unit including
3. On each .additional story of the dwelling, basements and cellars.
including basements, and habitable attics but 2. On levels with bedrooms, carbon monoxide
not including crawl spaces and uninhabitable alarms shall be placed outside bedrooms
attics. In dwelling or dwelling units with within ten (io) feet of bedroom doors.
split levels and without an intervening door 3. All alarm sounding appliances shall have a
between the adjacent levels, a smoke alarm minimum rating of 75 dBA at pillow height.
installed on the upper level shall suffice for 4. Interconnection is required.
the adjacent lower level provided that the
lower level is less than one full story below ❑ Additional Requirements: House number to be
the upper level. posted in accordance with Town of Barnstable
4. Near the base of all stairs where such stairs Regulations:
lead to another occupied floor. 1. Arabic numbers,contrasting color.
5. For each 1200 sq.ft.of area or part thereof. 2. House number visible from the street.
3. If numbers are not visible from the street,
❑ Maintenance: Maintenance of household fire they must be posted at driveway entrance or
alarm systems shall be conducted according to as needed.
manufacturer's published instructions. (11.8.1.4 NFPA 72)
Barnstable C.O.M.M. Cotuit Hyannis West Barnstable
508-362-33112 Phone 5011-790-2375 Phone 508-428-2210 Phone 508-775-1300 Phone 508-362-310 Phone
5o8-362-8444 Fax 508-790-2385 Fax 508-428-0202 Fax 5o8-778-6448 Fax 5o8-362-3683 Fax
�o13 - N33I
Bowers, Edwin
From: Grossman, Michael <mgrossman@commfiredistrict.com>
Sent: Wednesday, August 30, 2017 3:18 PM
To: Bowers, Edwin; Lauzon,Jeffrey
Cc: Shea, Sally
Subject: .140 Willimantic Drive Marston Mills
Passed smoke/CO inspection on 8/30/17
Sent from my iPad
I
I
' 1
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 42— Parcel 7 Application
Health Division Date Issued 71.3!��
Conservation Divisionl� Application Fe
Planning Dept. Permit Fee o2
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project Street Address V W u-I pwIV �G D4
Village
Owner ' <�/�►�i�U D Address SaK9� ,
Telephone .5`Off---77 I 33
RE
Permit Request �� LD,O �/�Z1/i/6�/?,U�lU2 G �1QD D6&� �Z
albf Imn.
Square feet: 1 st floor: existingproposed 2nd floor: existing proposed b ZLvTotal new l 7i
Zoning District Flood Plain Groundwater Overlay
Project Valuation 2 S',09a Construction Type r/-24AAr
Lot Size 15Z A Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
Age of Existing Structure 45 Historic House: ❑Yes 1�dNo On Old King's Highway: ❑Yes ❑ No
Basement Type: X Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing "2� new L Half: existing '� new
Number of Bedrooms: q existindo new
Total Room Count (not including baths): existing new 6 First Floor Room Count
Heat Type and Fuel: XGas ❑ Oil ❑ Electric ❑ Other
�,[ i
Central Air: ❑Yes �d No Fireplaces: Existing New Existing wood/coal stove: ❑Yes,9 No
betached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size I Barn: & existing,_I neA sizei/20
v S' o.
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other's `"'
Q
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review #
Current Use Proposed'Use
00
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name ���"�-JS'�- G(hUY?iZ15rQ1U Telephone Number
5bit-7e14-33
Address A�4 1A1/G!-/A4A1 -)ll License #
1*Y,_yDNS / uI5 , A118 024CI f�if' Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
re_-X 1N Lam ,
SIGNATURE DATE
} FOR OFFICIAL USE ONLY
APPLICATION#
u, DATE ISSUED
.s
MAP/PARCEL NO.
,r ADDRESS VILLAGE
1
OWNER'
f DATE OF INSPECTION:
°fvFOUNDATION
FRAME
1, INSULATION O
` FIREPLACE
ELECTRICAL: ROUGH FINAL
1 .
PLUMBING: ROUGH FINAL
` GAS: ROUGH FINAL
j FINAL BUILDING ''._
DATE CLOSED OUT
ASSOCIATION PLAN NO.
t
V
- The Commonwealth of Massachusetts
Department of Industrial Accidents _
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass govAha
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
A plicant Information Please Print Legibly
Name(Business/organiiztion/IndividuaI): �i /.1/1�L/S �.-•�'diJ
Address: 6VA(i/ Al /L,City/State/Zip: 11710 Z, A,Q d 14 4one#: ���` 7441(d`33 o d Z
Are you an employer?Check the appropriate box: Type of project(required):
1.0 I am a employer with 4. I am a general contra.ctor.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. XRemodeling
ship and have no emp ib-
loyees These stcontractors have g. Demolition
working for me m any capacity. employees and have workers'
[No workers' comp. insumce comp.insurance.t 9.. 0 Building addition
required.] 5. We are a corporation and its .10.0 Electrical.repairs or additions
a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself [No workers' comp. right of exemption per MGL
l insurance required.]t c. 152, §1(4),and we have no 12.E]Roof repairs
employees. [No workers' 13.[] Other .
comp.insurance required_]
*Any applicant that checks box#l-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
xContractors 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..
lam 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.Lic.#: 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 her c under the pains and penalties of perjury that the information provided above is true and correct
S Date:
PhcL#: U
OJYcial 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
fi..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."
partnership,association,corporation or other legal entity,or any.two or more ..'
An employer is defined as"an individual,p rship, -
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership, association or other legal entity,employing'employees. However the
not more than three apartments and who resides therein,or the occupant of the
owner of a dwelling house having
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house.
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be'an employer."
MGL chapter.152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance.coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the in¢rmmCe
requirements of this chapter have been presented to the contracting authority"
Applicants
Please fill out the workers' compensation affidavit completely,by checking-the boxes that apply to Your'situation and, if.
necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no-employees other than the i
members or partners,are not required to carry workers' compensation insurance' If an.LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial .
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of'
Industrial Accidents. Should you have any questions regarding the law or if you are required to obt ain a workers'
compensation policy,please.call the Deparhnent at the number listed below. Self-ins ed,companies should entertheir
ru
self-insurance license number on the appropriate.lime.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the.bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact-you regarding the applicant _
Please be sure to fill in the pe=jylicense number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only subunit one affidavit indicating ctnrezrt. .
policy information(if necessary)and under"Job Sits Address"the applicant should write"all locations in (city or
town)."A copy of the-affidavit that has.been officially stamped of marked by the city or.town may be provided to the . .
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled'ouf each
year.Where a home owner or citizen is obtaining a-license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
� The office �
of Investigations would like to thank you in advance for your cooperation and slibuld you have any questions,-'
please do not hesitate to give us a call.
I
The Departmenf s address,telephone and fax number '
The Commonwealth of Massachusetts
Department of Industrial Accidents '
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel, #617-727-4900 ext 406 or 1-977-MASSAFE
Fax#617-727-7749
-evised 4-24-07 www.mass.gov/dia
Town of Barnstable
'EKE r,
Regulatory Services
" Thomas F. Geiler,Director
t
i RARNf.TARf)t. F
, ' Building Division .
QED Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 509-862-4038 Fax:•508-790-6230
HOMEOWNER LICENIsE EXEMPTION
�y 0 Please Print
DATE v0 `
JOB LOCATION: ��1'�/ N/Ili�/I 4N'�u�
i ..street village
number ,
[S
HOMEUWTZER": ,vG G� z�v � ����
name home phone# work phone#
CURRENT 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
to allow homeowners to engage an individual for hue 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 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
1r
'inspection procedures and requirements and that he/she will comply with said procedures and
Signature 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 l
Building Code Section 127.0 Construction Control.
HOMEOWNrm,s EIO;IMIPTION i
The Code states that Any homeowner prrforming work for which a building perarit 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,pmson(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 responsrbitities,many communities require,as part of the permit application, i
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•fom,/certification.for use in your community.
.Q:forrns:horqI!:cenrpt - .
oFTHE Town of Barnstable
Regulatory Services
r AIRNf.T1RT_R s
names �, Thomas F. Geiler,Director
'��► Building Division
Tom Perry,Building Commissioner
200 Main Street,Iiyannis,MA 02601 -
www.towmbarnstable.ma_us
Office: 508-862-4038 Fax 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A`Builder
as Owner of the subject property
hereby authorize to act on my behalf,
in aI1 matters relative to work authorized by this budding permit
(Address of Job)
#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-
Signature of Owner. Signature of Applicant
Print Name Print Name
Date
WORMS:OWAERPERMMSI0NPOOL5 6/2012
The Town of Barnstable
BARNSTABLE. • Department of Health Safety and Environmental Services
MASS.
t67q. �0
MAC° Building Division
200 Main Street,Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
Inspection Correction Notice
Type of Inspection
Location ZV� IlVf C G 1 #4 g,ZZ/I c Permit Number
Owner (A)k 12.Z Builder
One notice to remain on job site,one notice on file in Building Department.
The following items need correcting:
6
Please call: 508/-886-2�403�for re-mspe ion.
Inspected by J
Date d(- ?C> /
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