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Home My WebLink About0125 WINDING COVE ROAD o v J r + ls l.C�l rl cll C' � �. 1 let;{ Town of Barnstable RECE 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-2216 Date Recieved: 7/13/2017 Job Location: 125 WINDING COVE ROAD,MARSTONS MILLS Permit For: Building-Insulation-Residential Contractor's Name: Carl J Rebello State Lic. No: CS-084358 Address: Swansea, MA 02777 Applicant Phone: (508) 567-4109 (Home)Owner's Name: PYNE,SHANNON M Phone: (508)681-8392 (Home)Owner's Address: 125 WINDING COVE ROAD, MARSTONS MILLS,MA 02648 Work Description: Insulation. = G r..�1 73 D. Total Value Of Work To Be Performed: $3,917.00 � 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 work 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 filing 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: Carl Rebello 7/13/2017 (508)567-4109 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Lotaroject Cost : $3,917.00 Date Paid Amount Paid Check#or CC# Pay Type ermit Fee: $85.00 7/13/2017 $85.00 Paypal Paypal ermit Fee Paid: $85.00 i Mckechnie, Robert From: Mckechnie, Robert Sent: Monday,June 13, 2016 9:58 AM To: 'Melinda M.Carneiro' Subject: RE: Followup Good morning, I apologize for not getting back to you sooner. After discussion with the other inspectors,the following will be required: 1.) An electrical permit for the work done. The work will have to conform to the current electrical code. This can be obtained by you or a licensed electrician through application at this office. Usually the licensed electrician will check the work to make sure it complies with the code, make any corrections and then it will be inspected and passed by the electrical inspector. I would suggest you hire a licensed electrician because they have a working knowledge of the code. 2.) A plumbing permit for the work done. The work will have to conform to the present plumbing code. This permit must be obtained by a licensed plumber. The licensed plumber will check out the work that was done, make any corrections and then it will have to be inspected and passed by the plumbing inspector. Once the inspections are complete, I will be able to sign off on the permit here at the office because of my previous inspection. For your information, we cannot recommend any contractors for you to contact to complete these requirements. Sincerely, Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 From: Melinda M. Carneiro [mailto:mcarneiro@comcast.net] Sent: Thursday, June 09, 2016 11:13 AM To: Mckechnie, Robert Cc: mcarneiroC&comcast.net Subject: Followup Good morning - . I am following upon my request for a building permit at 125 Winding Cove Road in Marstons Mills. When you came by on May 251h, we discussed how the plumbing and/or electrical inspector may also need to view the work. I don't believe there was anything I was supposed to do at that point but on the chance 1 . that I misunderstood and was supposed to call or email someone, I decided it would be best to follow up with you now that two weeks have passed. Any guidance you could provide to me would be most appreciated. Thank you - Melinda M. Carneiro mcarneiro@comcast.net (508) 420-0445 - Home (508) 846-5340 - Cell 2 j TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map r ( Farce TO��`� OF ��'�STASApplication # Health.Division 16 'Y { .M 9: Date Issued Conservation Division Application Fee Planning Dept. ..—._--Permit Fee Date Definitive Plan Approved by Planning Board Historic OKH _ Preservation/ Hyannis reo Projec�reet 8ddressa lM villa e-:Vo rSfn r, k,U S Owner elt' rnek) 45c�-Wr no�Vu Address TelephT�on^ e (.50B) 8k4(o- 5?t-4z:_-> Perrrmit_Request �r"'O} �� .�l 4 ' Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project valuation IIDD Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) .Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: . ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name _e=AA vP (in a A C��,��2 i fb Telephone=Number 6 L99 84 - 5'3tfb Add r--e- ss a5 ` License # Home Improvement Contractor# Email (A C a r n P_ic-o(off Cx>m4 aS-t. Vl,CV Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNAT_U.RE ` -Al � 4� f. ( �cJ�i+.t�.�,u� DATE 0 S�i�1s.o16 • FOR OFFICIAL USE ONLY G APPLICATION.# DATE ISSUED MAP/PARCEL NO. A - ADDRESS VILLAGE OWNER - DATE OF INSPECTION: . - r FOUNDATION = FRAME ti INSULATION FIREPLACE [s ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL g GAS: . ROUGH FINAL FINAL BUILDING ' } DATE CLOSED OUT ASSOCIATION PLAN NO. 27ze Comormweahi afMaywdinset is ��e�zt of�n�strial�iccir��tr Office qfLwesdgadons 600 Wasbuzg on Sbwl Boston,MA 02M >'vrmmasmgorldza Workers' ComipensafirnInszwmce Af Edzvit:BuflderslCaufi-achn-{EI " ns fibers Applicant Informafign Please PFint E,e�'bIy CitglSi t� t Phone 4 5P�5 &•f(P Are ywu an employer?Checkthe appropriate box: Type of project(reguired): 1.❑ I am a employer with 4. ❑I am a general contractor and I 6- ❑New eonstituctica employees(faU aad&r partrfime).* have hued the sub-contractors 2.❑ I am a sole proprietor orpartmer- listed on the attached sheet 7- ❑Remaodehng sfiip and have no employees These sub-contractors have g ❑Demolition woridag for nee it any capacity. employees amd ha<<e x�ozkers' INQ w0dous,Damp.insurance comp.4„ , 1 9. ❑Building addition required j 5. [J We are a corporatiza and its 10-❑Etec 1 repairs or additions i3 0�a�a bameou�er doing au iRork officers have exercised their ME]Plumbsngrepaiss or additions o workers' right of exedrplion per M L ❑ €� cOimF- 12_ Roof ;nsurarc•required-]y a 15Z,§1{4k aadwe have no employees.[No wodoess' 13.0 Other comp-inmmme require&] • Amy agffutcbeclubox#lnmst also finwtthesectimbelewshmsbgdmirwozIen;comp ensatinupoycyi�mmadam. 1 H=eov n=w]m sabot fts dfidna inaffc¢ting submit anew affidaek indirchn salt. TCamactoathar cbecl<thfs box mast attaches!as additioaal sheet shaaingtheaameof @be sub- aMd statewheflM arnot h,,e eutitiesbne employees.T€theanbta�ctnshsseemgIoF�s,tfiegmustgmvideth�8orkms'�,RP�F�� lam an surpL ar Seat is protJiding�uarksts'caarperesair'are iiesurarres far nay etrrplay�ee� Below is Me paHc y aced job site informadom In.Furance CormpaayName- "Policy:ff or Self-iri&l ic.f Expiration Date: Job Site Address: City/StaCWTAP: Aflach a copy ofthewarkers'comapensationpolicy declaration page(showing the policy number and expiration date), Failure to sew coverage as requiredunder Section 25A o€MQ.r—152 can lead to the itaposition of criminal penalties of a fine up to S l,50D Oa and/or one-year imprisonnterd as well as civil peaslfies,ia the form of a STOP WORK ORDERand a fine of up to$250-00 a day against&a violator. Be advised drat a cagy of this stafemernt stay be Ekwarded to the Office of Investigations of tare DIA€m innuance:coverage veafrc a ion. Ida ken&y earlF;f�under Sgspains andpauaWm afperju y that firs ir�orma€iauprm hW abzn a is bare and correct d ic-e�-``7 Dale- 5�t o �7�t1 lib Phone#: Ojokiat airs wily. Do not wrote in dais area,tit be cmapkesd by city artolm a oldnL City or-fawn: PerusitlLicense;9 Issuing Authority(curie one): L Board of Realt€r Z.Building Department 3.Cityrrown Cork 4.Electrical Inspector S.Pbmmbing Inspector 6.Other Contact Person Phone#- ormation and lastrxctions ' :a Massar-h of is Gateaal Laws chapter 152 regonrs aU eo3Ioyess to provide waJOeas'comPensation for ti==ployees. this statute,an eenpInyee is dcfned as=every person in ffie service of anotbzr under any co aft-act of hire, express or implied,oral orwrhtenf An e2vp&yer is defined as"an filaTiffimL pmtieasbip,a=dzfio corPoxafion or other legal entity,or any two or more of the f M7Cgoing engaged in a joint else,andia the legal reprMeafxfives of a deceased employer,ar 1he receivrr or trustee of an individual,part =3133p,assod d=or other Iega1 entity,employing employees. However the owner of a dwelling house having not more than tl¢ee apartments and who residas f=cm,or the occagad of the- dw•eaing house of another who employs pmsons to do mace,comsh ucti on or repair vac an such dwelling house or on the grounds or building appu�Thereto shaR not becanse of such employment be deemed to be a a employer-" MGL chapter 152,§25g6)also stairs fly"every state or IocaI Tlcensm- g agency shall withhold ffie issuance or renevvaI of a Tic— a or permit to operate a business or to construct buildings in the co— for any applicantwho has not produced acceptable evidence of compliance wii3i the hnmxanm coverage required" Adcaionaily,MM chapter 152, §25C(7)states-Teftherthe co*n ng:o nor ray ofitapoIhical subdivisions shall enter into any contract for the pace ofpnblic work until acceptable evidence of compliance vMh the ms� .. regoirenien s of this chapter have been presented to the contracting aothouty." Applicauft , Please fill Out lie works'compensation affidavit comPletely,by checking the boxes that apply to your situation and,if necessary,supply snb-contacbor(s)name(s), addresses)andPhoneaumber(s)alongwiththc:rcertifrcate(s)of i omrance• Limited Liability Compames(TLC)or Limited Liability-Partoersbips(LI.P)Wuhan employees other fhan.the members or partners�are not reqcdred to easy workers'compensation in saran If an LLC or LLP does have empIoyeCS a policy is required. Be advised that this affidayitmaybe smbmitted to the Department of Industrial Accidents for conf nation of insmmce coverage. Also be sure to sign and date ithe affidavit The affidavit should be reined to tile,city or town 13�the application for the permit or license is being requested,not the Department of rein Iudn etriai A=dc ts_ Should you have any questions regarding the law or ifyon are reed in obtain a wogs' compensation policy,please call the Department at fire number listed below. Self-bsimed coropanies should ear their self ins ce license numbs on the appropriate line City or Town Officials Please be sure that the affidavit is complete and printed IegilIy. The Department has provided a space at the bottom of the.affidavit for you to fdl out in the event the Office ofInvestigaiions has to conisct you regarding the applicant_ Please be smz to fill in the pe:oi0ic;se nwnber which will be used as a reference z=ber. In addition,an applicant that mast submit multiple p=aWIiceose applita ions in any givca yen',aced only submit one affidavit indicating cuarnt p olicv information Cif necessary)and under"lob Site Address'the applicant should writ✓"al[locations in (city or town)-"A copy of the-affidavit t3iat has b=aa officially stamped or mmkcd by the city cr town may be provided to tie ' applicant as proof that a valid affidavit is on file for ibfure peonity or lieenses_ A new affidavit must be filled out each year.Where a home owner or caii=is obtaining a license or peonitnot reaatod to any business or commercial veaxue '(ie. a dog license or permit to bum leaves etc.)said person is NOT required to campletu this affidavit The Of of Inyesfiggji s would ilb-_to thank you in advance for yom cooperation and should you have any questions, please do not hesitate to give us a caI L lie Department's address,telephone and-fax rmmbe: _ of Mzssachm seM . D:faent cif Ian Acc�enis ��ashmgban��free� Bt MA 0�111 Tf,-L 4 617 727-4944=.t 406 or 1-M M&SSAFE Fax 617 727 7749 IZevised42"7 -gagfd a I AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(790 CMR 5301.2.1.1)' L1 Cbek 1.1 SCOPE Compliance WindSpeed(3-sec.gust)...................................................................................................................110 mph — WindExposure Category...............................................................................................................................B 1.2 APPLICABILITY Number of Stories .........................................................-...(Fig 2)............................ stories S 2 sto _ RoofPitch ....................................................................... (Fig 2) ........................................... - :12 MeanRoof Height ..............................................................(Fig 2)_............._................................ 5 33' BuildingWidth,W......................_.......................................(Fig 3)........................_...................... It S 80' BuildingLength,L ......................................... (Fig 3).......................................... ..—ft 5 80' ................... .... _ Building Aspect Ratio(LIW) .......g...............:.. .................(Fig 4)............................................. .. s 3:1 Nominal Height of Tallest Openinz ..............I.... ..............(Fig 4).......................................... .... - 1.3 FRAMING CONNECTIONS General compliance with framing connections................ ..(Table 2).............................. ..................... 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 ConConcrete Masonry................................................................... ......... ........................................ _ 2.2 ANCHORAGE TO FOUNDATION'' 5/8'Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as a to ' e In concrete only Bolt Spacing-general..........................................(Table 4)...... ............... ................I..... in. Bolt Spacing from endrolnt of plate ............................(Fig 5)....... ...................... .... in.S 6"-12" —_ Bolt Embedment-concrete.........................................(Fig 5).... ............................ ............. in.;!T Bolt Embedment-masonry.........................................(Fig 5).. — — PlateWasher...............................................................(Fig 5 .......................................... ..Z Y x 3"x'/." — 3.1 FLOORS Floor framing member spans checked ............................... r 780 CMR Chapter 55).......................... ........ _ Maximum Floor Opening Dimension................................... lg 6)............................_It S 12'or U2 or 2 _ Full Height Wall Studs at Floor Openings less than 2'fro Maximum Floor Joist Setbacks erior Wall(Fig 6)................................ . - j Supporting Loadbearing Wails or Shearwall........... ...(Fi .................................................... ft S d Maximum Cantilevered Floor Joists -- — Supporting Loadbearing Walls or Shearwall................(Fig 8).................................................... FloorBracing at Endwalis...................................................(Fig 9)...................................... :............... ft s d — Floor Sheathing Type ........................................................(per 780 CMR Chapter 55).......................... .......(per 780 CMR Chapter 55)....................... in. _ Floor Sheathing Thickness....:.............. — Floor Sheathing Fastening..................................................(Table 2).._d nails at_in edge/_in field _ 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig 10 and Table 5)..........................._ft 5 10' Non-Loadbearing walls............................................... (Fig 10 and Table 5)........................... ft S 20' _— Wall Stud Spacing ........................................................(Fig 10 and Table 5)..................._in.5 24"o.c. _ Wall Story Offsets ...............:........................................(Figs 7&8)............................................ ft 5 d _ 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls........................................................ able 5 ......2x _ ft_ Non-Loadbearing walls................................................(Table 5)..............................2x -—ft—in. Gable End Wall Bracing' — Full Height Endwall Studs............................................(Fig 10)........................................... _ WSP Attic Floor Length................................................(Fig 11)............................ _ft 2 W/3 ................. Gypsum Ceiling Length(if WSP not used)...................(Fig 11)............................................_ft a 0.9W _ 2 x 4 Continuous Lateral Brace @ 6 ft.o.c...(Fig 11)....................................................:....... Double Top Plate — Splice Length .............................:.............(Fig 13 and Table 6)..................................... ft _ Splice Connection(no.of 16d common nails)..............(Table 6)........................ .................................. i A WC Guide to Wood C nstruction in High Wind Areas: 110 mph Wind Zone Massachusetts ecklist for Compliance(7so CMR 5301.2.1.1)' Loadbearing Wail Connections Lateral(no.of endnailed 16d co on nails)..............(Table 7)........................................................ Non-Loadbearing Wall Connections '— Lateral(no.of endnafed 16d corn on nails)...............(Table 8)............................ Load Bearing Wall Openings(record la est opening but check all openings for compliance to Table 9) HeaderSpans ......................... ............................ (fable 9).................................._ft in.s 11' SillPlate Spans .......................:...............................(Table 9).................................._ft_In.'s 11' Full Height Studs (no.of studs)..................................(Table 9).............._........................................ _ Non-Load Bearing Wall Openings(raw largest opening but check all openings for compliance to Table 9) HeaderSpans............................................................(Table 9).................................................................._ft_In.:5 12' SillPlate Spans.............................. ............................(Table 9).................................. ft_m.512' Full Height Studs(no.of studs)........ ... ......(Table 9)........................................................ Exterior Wall Sheathing to Resist Uplift a d Shear Simuitaneousi 4 — Minimum Buiidin Nominal-Height of Tallest O ning2 .......................:�� .................................................._5 6'8- _ Sheathing Type.............................................(note .... Edge Nail Spacing............... ..... .. (T "10 or note 4 ff less)........................—in. Field Nall Spacing —� p 9..................................... able 10).................................................—in. _ Shear Connection(no.of 1 common nai�s)(Table 10).......... _ Percent Eull-Height Sheathin ........... ..........(Table 10)...................................................._% _ 5%Additional Shea ng fo all with Opening>6'8'(Design Concepts).............. ... Maximum Building Dimension,L Nominal Height of Tallest Open ......................................................................... 5 6'8° _ SheathingType.............................................(note 4)...................................................... Edge Nail Spacing.........................................(Table 11 or note 4 if less)........................ in. _ Field Nail Spacing..........................................(Table 11)................................................._in. _ Shear Connection(no.of 16d common nails)(Table 11)...................................................... Percent Full-Height Sheathing.......................(Table 11)................................ .................... 9'0 _ 5%Additional Sheathing for Wall with Opening>6'8'(Design Con cepts)......................0/0 Wall Cladding Ratedfor Wind Speed?............................................................................................................................. 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) _ Roof Overhang ...................................................(Figure 19).............. It 5 smaller of 2'or L/3 Truss or Rafter Connections at Loadbearing Wails Proprietary Connectors Uplift............................................._(Table12)............................................U= pif Lateral.............................................(Table 12).................................. lf Shear................................:..............(Table 12)..................................... p ........S= pf Ridge Strap Connections,ff collar ties not used per page 21.....(Table 13)..............................T=_pif Gable Rake Outlooker.........................................(Figure 20) _ft 5 smaller of 2'or L/2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)............................................U= lb. Lateral(no.of 16d common nails)...(Table 14)...............................A......L= lb. Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59)............ . Roof Sheathing Thickness........................................................................................._in.a 7/16'WSP Roof Sheathing Fastening...........................................(Table 2).................................................. Notes: — 1. This checdist must be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1.ff the checklist Is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a 2. Exception:Opening heights of up to 8 ft shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.'nominal thickness.pressure treated#2-grade. AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301a.1.1)' 4. a. From Table 10 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing requirements b. Wood Structural Panels shall be minimum thickness of 7/16'and be installed as follows: I. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. ill. On single story construction,panels shall be attached to bottom plates and top member of t double top plate. iv. On two story construction,upper panels shall be attached tdthe top member of the>upperbZble top plate and to band joist at bottom of panel.Upper attachment of lower panel shall be o band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists, W d girders shall be a do le row of 8d staggered at 3 inches on center per the Figure, Vertical a Horizontal Nailing f Panel Attachment i A WC Guide to Wood Construction in High Wind Areas. 110 mph Wind Zone Massachusetts Checklist for Compliance(7so CMR 5301.2.1.1)' -YA-M THU EDGE REMS ON FFAMMGuse8d NAXS AT Bbim —S - ===11T=-1 -- v 14 111 11 r 11 It 1 t1 11 1 11 11 �S O hdo r'I� a 1 b 1. jr n i� C li Ir � r 11 Jof 09 ii it s IL Ij Q ii r/ 0 11 �t 1 14 11 11 n r% NMSPACW3 See DaWl on Next Page Vertical and Horizontal Mailing for Panel Attachment Town of Barnstable Regalafary Services Richard V.ScA DhmcWr ` Bulding Division 200 Mam St=t g9=dr.,MA 02601 • www t nm.33 stablesaa us office: 5084624.038 Fas 508-790-6230 Property Owner Must . Complete aad Sign This Section If Using ABuilder as Qwner of the snbjectpzoPerY lierebpasx�orize to act on mybel . k an zaatir relative to Volk ar u&-ed bm[ding pezaat application for. (Address of job) Pool fences and alatms are the zrspons of the applicant.Pools are not to be filed or 49 zed befo ' ence is and all final al ' inspections.are performed and pted-. Sig at= of Owner Sknat=e of Applimul: PNa� Pant Name Data . Q�:o oars . Town of Barnstable Regdafory Services ". Riewwr•d V.S=4 Director Tom Petry,Eftlidmg C3ommissionax 200 Main.Strect ffy=q,MA 02601 ®!� �,�ptign„�arnriaRT�ma� Office: 509-9624-038 Fs= 509-790-:030 . PlrZsePrimt rnsabcr ; Wr�x 11�l G'ndQ �a�1 o Pro v�a phcnof �rarrn -GAD CQBBfNt- - — , _ zip Cade 1be cnaeut for`�omcowne 'was to mcbadc owner-0cepied dweIImes of sac IMiS ar Icss aid to ZOO home-ovm=to.wgage an iacRvidnal for bimwho does notpossess a license,gtovided tbat&M owner ad mr s as soovisor. • D�F'IIaI'II]N ORHO�W]:�S P=on(s)who owns a parcel ofland oa which hdsbc resides ar mf-uds to redd on wbi ibeaa is,or is inionded is be,a one or two- f mniily dwaT]m�attachtd or debdmd strud�s accessory to surly use and/or farmtr�ses. A poison who const uc4s n%c=than ono hnma in a two-ye=period sbaU aatbe cone&rid;.homco Such%=wwnee.shaU mbmitto the BmUing Of5Lial an a tisun aexptabla to ti=Bur3dmg Off mat ffiat he/abc shan be MRmmbla f m an such walk peram ed umdw-ffm bmIjT=permit (Section 109.L1) Tha uad ed`han=wnce assmnrs respnnssbifdy for conrpflianrx wifiithe State Building Coda and o Cr apgficabIa codes, byiaws,rales and=akt ans_ - ZIu=geed`han cowner"cerdfcs thathchbn uadcatmds tba ToYM of:Bamsbbla BmWmg Depabn=±t mspmd ml procadmrs regm=n=mts aadffhathelsho wM comply WIEL said pm=dn=aadxzqPa=cm±s- �' t� Y cfB7Udmmg Offidal Nora: Tbroe-ftailYdvcniap c 35,000 whirfmtorlarg=wMbereqt&edto copf9wiihtbaSimB-lfiin Cods Secdcm f27.0 r`o��'' C, &aL 1be Code stets that aAuy homeowner performing work fir which a buz-T palm&is required shaII be enempt from the provisions of this sedna(Section 109.L1-Liccasing of coast mown Supervisors),provided mat if Sie homeowner engages a persons)for hire to do such work,that saeh Homeowaar shaIl act as supervi5w." Many homeowners who use this eamgfron axz tmaw-dre.fhatflLeY are m *mhg the responstbr'f�us" of a mparvisor C=App. Q,RxIms&ReguFafians forz;cLrdngg Cnnwft csnn SQpereisors,Serfian 2J5) 'Ibis lack of awareness often. res l fa in serious problems,p=ficalarly when the homwwner hires mmfnaensed persons. In ffi7s czst�our Board cannot pro=ed agemst the m neensed parson as it would wide a Rcensed Supervisor the homeowner acting as Supervisor is altfmate responable wan w as of To aaszu a that f e,homeowner is SsIIp aware of hislhax r esponsibi6es, y require, 1?�. fka permit$ppIiratun,that the homeowner certify that he/she understands the re;por w-bT3f rs of a Supervisor. Oa f3ie histpage of ffiis hmm is a fhrm enrrea$y used by,sevar d fnwas You[may caret amend and'adapt such a forml6ertificdion.fmr use in your commmdtp Bavi=d 061313 Mckechnie, Robert From: Melinda M.Carneiro <mcarneiro@comcast.net> Sent:' Friday, May 20, 2016 9:28 AM To: Mckechnie, Robert Cc: mcarneiro@comcast.net Subject: RE: Permit Application for Bsmt Area Importance: High a Good morning — 0Pereis I believe I have the information you requested which I will detail below. Please let me know if anything else that I can provide. Thanks in advance for your attention to this request. #1) The finished headroom is 7' 3". #2) The room has two return vents for heat, central air and fan all connected to the house system. The 2 bath also has its own fan. #3) In the finished space there is a smoke alarm and a CO2 detector which is just beyond the entrance i to the room and in the room itself. These were placed as directed by the Fire Dept. . The basement itself has several more smoke alarms and CO2 detectors that are in the unfinished portion. Regards - Melinda M. Carneiro mcarneiro@comcast.net From: Mckechnie, Robert [ma ilto:Robert.McKechn ie(aDtown.ba rnsta ble.ma.us] Sent: Thursday, May 19, 2016 4:05 PM To: mca rneiro0comcast.net Subject: Permit Application for Bsmt Area Good afternoon, The following information is needed in order to process your application for the building permit: 1.) The finished headroom is not shown on the plan. Please provide this. 2.) What will be used to provide the required ventilation in the finished space? 3.) Where are the smoke alarms located at the present time? You can provide this information by email if you choose. Thanks, v Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 z I 2 skJ ooM OF4 C-p. --1 lit at�ns p av� ►�1� Win L� :bWlff , ; 9;u 919visMu'vo Jib 1`°11,401 =� ,.. _--___.. �---� �..-1�-, - 1•• ... ��...; 1 _ __ �v7- t �� 1 _ � - - ��E ��'� Q� Q� _ rn `OFI�SIKggqE TO Town of Barnstable BARNSTABLE.p• Regulatory Services MASS. 0 039. a Building Division ArFO MPS 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 i Inspection Correction Notice Type of Inspection Sr z'E Location Permit Number Owner Builder AJ11 One notice to remain on job site, one notice on file in Building Department. The following items we'-e- obs-«-u ej -S Le `g 5Ae�v� n STruz7�Cf� o� �i`�✓e/`�y - e ins L`�ea� 4-5 ez- ae e- L41G X14 0 J 1AAl. �S/° S�z r/o 3 /A4U I is. yy�ie/'ior fyas /3eerg -�4*-Z- 7V607-&9e No /�tj•�,�ipooN� �aR►4 c—�Nr 0wA.2e1C G/sEs 1 -A,01? &s 4 LO UC Tic x `3 jo s- #;ks!t►&s 4&rb 1- r3rAC-K �Ar:� NotE: � r�1t 199 S�i Z /& M vr-A*20!Z 9639 u 1012- yo 3-7 Please call: 508-862- Inspected by Date �/Z�� p`pF�NE ip�� Town of Barnstable BARNSTABLE. Regulatory Services MASS. t°3 a Building Division piEO MAC 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice .e t Type of Inspection 51 7-c Location S Gl/i/tu6YN C oUE/f"/� dl�df Permit Number �V/o Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items t ..= - K �✓Pie o6 s �„ 12 n c1 / S.�c r 5/JPC�7cYl - J/f uG to or) ��,��/��y ' �� -/V� weal cis cc 6ave'- e � `10 /p) IrIA1,4L. 0.,41o3 s. �I►��-fio/- WC.S 14Qee7 c&1- 7LI6=XTc IV- 19,47 �ur?Y�Fair QGcJN�/2 �15E-� �T 7 0l' �7�l�q �sE N� 1 s ,4 Couc/� 4A.)/) 6WA91n165,'� /NSl-AE {o!� (�9kg6f .a 3 065 - 2 Alk AND 1 1�LimcK I Af:� q SC-wu/cE �)b6 . Please call: 508-8-862- Inspected by Date %/L �/'71 I Parcel Detail Page 1 of 4 IHF Aft- Logged In As: Parcel Detail Tuesday,April 22 2014 Parcel LookuD Parcel Info Parcel ID 057-048 -I Develop Lot LOT 73 Location 1125 WINDING COVE ROAD I Pri Frontage 1170 Sec Road I Sec I Frontage Village IMARSTONS MILLS I Fire District I C-O-MM Town sewer exists at this address I No ( Road Index 1854 Asbuilt Septic Scan: Interactive ��` 057048 1 ' Map Owner Info Owner IROY, SUZANNE C &CARNEIRO, MELINDA M I Co-Owner Streets 1125 WINDING COVE ROAD I Street2 F — City IMARSTONS MILLS I State MA zip 102648 Country Land Info T Acres F0.56 , Use I Single Fam MDL-01 I zoning IRF i Nghbd 0108 Topography(Aboye Street I Road ,Paved Utilities jPublic Water,Gas,Septic I Location�— Construction Info Building 1 of 1 Year 1989 I Roof Gable/Hip I Ext Wood Shingle Built Struct Wall Living 12240 I Roof Asph/F GIs/Cmp entral ( <�' �' Area Cover Type 4 WDK 1- Bed Style;Ranch I wali Plastered �I Rooms 3 Bedrooms Int Bath oor 2Full+ 1HModel;Residential Rooms FlC BAS Heat Total Grade Average I Type Hot Air I Rooms 8 Rooms Stories 1 Story I Heat IGas —"I Found-'Poured Conc. Fuel 1 ation Gross 5432 Area Permit History _. http://issgl2/intranet/propdata/PareelDetail.aspx?ID=3767 4/22/2014 ` Parcel Detail Page 2 of 4 Issue Date Purpose Permit# Amount Insp Date Comments 10/28/2013 Insulation 201307492 $2,426 6/30/2014 12:00:00 AM INSUALTE-AIR SEAL 10/2/2002 Out Building 64160 $23,000 3/11/2003 12:00:00 AM GARAGE 11/1/1988 Dwelling B32446 $135,000 1/15/1990 12:00:00 AM MM 1 STOR - Visit History Date Who Purpose 1/9/2013 12:00:00 AM Denise Radley Change of Address 5/15/2012 12:00:00 AM Tony Podlesney In Office Review 1/19/2012 12:00:00 AM Nancy Finch Sale Review 10/5/2005 12:00:00 AM Paul Talbot Meas/Est 3/11/2003 12:00:00 AM Martin Flynn Bldg Permit Completed 10/17/2002 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 4/29/1999 12:00:00 AM Frederick Stepanis Meas/Listed-Interior Access 2/15/1990 12:00:00 AM IME I Meas/Est Sales History Line Sale Date Owner Book/Page Sale Price 1 12/16/2011 ROY, SUZANNE C &CARNEIRO, MELINDA M 25929/213 $450,000 2 5/15/2002 HEFFRON, STEVEN J&ANNA E 15159/124 $395,000 3 5/15/1983 BARTOLONI,JOSEPH A&MARY L 3738/227 $18,000 Assessment History Save# Year Building Value XF Value OB Value Land Value' Total Parcel Value 1 2014 $160,000 $57,200 $28,500 $210,500 $456,200 2 2013 $160,000 $57,200 $28,800 $210,500 $456,500 3 2012 $177,300 $59,000 $31,300 $204,800 $472,400 4 2011 $246,200 $3,400 $25,300 $204,800 $479,700 5 2010 $246,200 $3,400 $25,900 $216,200 $491,700 6 2009 $252,400 $2,800 $20,400 $262,600 $538,200 7 2008 $306,300 $2,800 $20,400 $250,200 $579,700 9 2007 $304,400 $2,800 $20,400 $250,200 $577,800 10 2006 $284,800 $2,800 $20,900 $246,000 $554,500 11 2005 $258,900 $2,800 $21,300 $186,400 $469,400 12 2004 $216,700 $2,800 $21,500 $186,400 $427,400 13 2003 $230,200 $2,800 $0 $89,700 $322,700 14 2002 $230,200 $2,800 $0 $89,700 $322,700 15 2001 $230,200 $2,800 $0 $89,700 $322,700 16 2000 $184,200 $2,800 $0 $70,100 $257,100 17 1999 $184,200 $2,800 $0 $70,100 $257,100 18 1998 $184,200 $2,800 $0 $70,100 $257,100 19 1997 $194,700 $0 $0 $36,600 $231,300 20 1996 $194,700 $0 $0 $36,600 $231,300 21 1995 $194,700 $0 $0 $36,600 $231,300 22 1994 $168,700 $0 $0 $28,000 $196,700 23 1993 $168,700 $0 $0 $28,000 $196,700 24 1992 $191,800 $0 $0 $31,100 $222,900 25 1991 $192,000 $0 $0 $66,200 $258,200 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=3767 4/22/2014 Parcel Detail Page 3 of 4 4 f I 26 1990 $0 $0 $0 $66,200 $75,700 27 1989 $0 $0 $0 $66,200 $66,200 28 1988 $0 $0 $0 $35,100 $35,100 29 1987 $0 $0 $0 $35,100 $35,100 30 1 1986 1 $0 $0 $0 $35,1001 $35,100 Photos r ,tom' fl••' I 71 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=3767 4/22/2014 Parcel Detail Page 4 of 4 i �k. http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=3767 4/22/2014 i TU PPE R CONSTRUCTION CO.LLC 79B MID-TECH DRIVE,WEST YARMOUTH,MA 02673 PHONE: 508-77"111 FAX: 508-778-5010 WWW.TUPPERCO COM I Date: dr , Town of Barnstable Thomas Perry CBO 200 Main Street Hyannis, Ma 02601 (508) 790-6230 fax e�q L Re: Insulation Permits o Ij Dear, Mr. Perry � w � .. a Uj This idavit into certify that a k completed for permit application Issued on has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State requirements*. Sincerely, l Permit #:��l� � Address: ✓ , Richard Tupper License # CS-69058 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map O 1 7 Parcel U Application oo-( Health Division Date Issued Conservation Division Application Fee { Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis a Project Street Address /,O� //J,D/f Dom- A& 9&44S M1 0,7 Village Owner �Gl !/�/7� ® Address CjD vC � Telephone Permit Request��1 �/ IQ;,, ..1, /r �/,. Q k6fz i 1)4 -b 0 v fc- t-de a M CA OLf CLA L- f�4bl CO yC1�___ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation o2 dv 0119 Construction Type CD Lot Size aJRe C cr" Grandfathered: ❑Yes ❑ No If yes, attach su rting doeumenfa `71 tion. �-. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) `- G, Age of Existing Structure / Historic House: ❑Yes ❑ No On Old King's Righway: OFYes No Basement Type: Q�<1I ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) U 3 Number of Baths: Full: existing new Half: existing new Number of Bedrooms;� existing Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ®-Gas ❑ Oil ❑ Electric ❑ Others_ Central Air: Wes ❑ 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: 62r/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��3 6A a4 'k — Telephone Number Address 7%A 1�216 Z&_44C License # Cl 00 06-9 VA cm M /V 4c)6 Home Improvement Contractor#/vZ Worker's Compensation # (4m5J93 a l a0D ALL CONSTRUCTION DEBRIS RESULTINP FROM THIS PROJECT WILL BETAKEN TO:;3L/:�> M SIGNATURE DATE FOR OFFICIAL USE ONLY " APPLICATION# DATE ISSUED MAP/PARCEL NO. 'f r ADDRESS VILLAGE z t OWNER a DATE OF INSPECTION: . ;F00.UNDATION<UgfljUkt)LfijWIXIM0Af'yr� FRAME -- — — — - — 'z ,tINSULATION sg.Aw . + FIREPLACE t r ELECTRICAL:,. ._ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING•-.._ DATE CLOSED OUT. N NO. ASSOCIATIONS PLAN y; . t The Commonwealth of Massachusetts Department of Industrial Accidents h Office of Investigations j I Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): Tupper Construction Co. Inc Address: 79B Mid Tech Drive City/State/Zip:West Yarmouth, MA 02673 Phone#:(508)778-0111 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ T am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling shipand have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' insurance.[ 9. ❑ Building addition comp.[No workers' comp. insurance P• required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 l.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 1.52, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] Any applicant that checks box 41 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance Company Name: AEIC Policy#or Self-ins. Lic.##: WCC 5005593012007 Expiration Date: 10/3/14 Job Site Address: 2 � j�com�pensa /A/e' City/State/Zip_MGi/�lTd41�i11 14a Attach a co of the workers' tion olic declaration a e showin the olic number and expiration da>�).PYpolicy page g policy 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 for insurance coverage verification. I do hereby cInv fy u er t e pains and penalties of perjury that the information provided above is true and correct Signature: Date: /0/i U Phone#: U` l iOfficial 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#: `-ACORD, CERTIFICATE OF LIABILITY INSURANCE =2013 D/YYYY) 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 EIELOW. 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 CONTACT NAME: Lora Lowe Southeastern Insurance Agency, Inc. A N° Ert: (508)997-6061 ^" (508)990-2731 439 State Rd. E-MAIL Farc NO ADDRESS: P.O. BOX 79398 PRODUCER CUSTOMER ID fk N. Dartmouth, MA 02747 INSURERS)AFFORDING COVERAGE NAICB INSURED INSURERA: Arbella Protection Insurance Tupper Construction Co LLC INSURERS: AEIC INSURERC: CNA Surety 27 Roberta Drive INSURERD: West Yarmouth, MA 02673 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 2013/14 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. 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 BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADD SUB IP�CCY EFF POLICY EXP nrfM LIMITS INSR WVD POLICY NUMBER GENERAL LIABILITY 85 08743 11/01/2012 11/01/2013 EACH OCCURRENCE S 1,000,00 X COMMERCIAL GENERAL LIABILITY PREMISES Ea ocw ence $ 100,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) S 5100 A PERSONAL&ADV INJURY S 1,000,00 GENERAL AGGREGATE S 2,000,001 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00( POLICY PRO- JECT LOC S AUTOMOBILE LIABILITY 5666240000 12/01/2012 12/01/2013 COMBINED SINGLE LIMIT 5 ANY AUTO (Ea accident) 11 000,00 BODILY INJURY(Per person) $ ALL OWNED AUTOS A X SCHEOULEDAUTOS BODILY INJURY(Per accident) S PROPERTY DAMAGE X HIRED AUTOS (Per accident) S INC X NON-OWNEDAUTOS S $ UMBRELLA LIAB X OCCUR 460005836 0=1/2013 11/01/2013 EACH OCCURRENCE S 1,000,00C EXCESS LIAB CLAIMS-MADE A AGGREGATE S 1,OOO,OO DEDUCTIBLE S RETENTION S S AND EMPS COMPENSATIONLI (LIT WCC5005 59301200 10/03/2013 10/03/2014 X WC STATU- X OTH- ANDEMPLOYERS'LIABILITY_ Y/N TORY LIMITS ER ANY B OFFICER/ME BER PEXCLUDED?ECUTIVE� NIA RICHARD (UPPER I E.L.EACH ACCIDENT 5 1,0U0,00 (Mandatory in NH) INCLUDED FOR WC COVERAGE E.L.DISEASE-EA EMPLOYEE S 1,000,00( If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,00 C on for the t o money & or 7106881 02/28/2012 02128/2 113 Limit of $10,000 roperty. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. "For Information Purposes Only" Tupper Construction Co LLC AUTHORIZED REPRESENTATIVE 27 Roberta Drive W Yarmouth, MA 02673 Lora Lowe ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD -fit`E"I 1 mass save caNT Rrcoe PERMIT AUTHORIZATION FOR i owner of the property located at: (Owner's Name,printed)! ��'s^-S ��C (Property.Street Address)✓ (City/Town) hereby authorze the Mass Save Horne Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. 0 � Owner' ignature 0�1�,1c Date FOR CSG OFFICE USE.ONLY Conservation Services Group has assigned the following Mass Save Home Energy Semites Participating Contractor.to he.above referenced project: Participating Contractor Date Rev.12132011 UU1LI31Plti FkKFUKMANUt:~11 Ulk,INC Massachusetts-Department of Public Safety 107 Hammes road,Suite 110 AINNUL Board of Building Regulations and Standards AM81W NY 12020 (877)274.1274 C m:U'urtin Supervl, r www•boi.0orn License: CS-069058 a RICHARD S TUPPER 79 B MID-TECH DR' s :t- �_ WEST YARMOUTH MAT0267'3 Richard Tupper BPI100:s0e4c t iF:R i lCFiii� � t � ' ;,'k41 :' .'� `%G..• wit , ` ' Expiration K ISE£REARSE SIDE FOR MSQMTRNfS A14D MRATIM)UTES;, Commissioner 12/31/2014 All el'�Iwftllwlaa 0/1 A&U�04� Office of Consurotr Affairs&it siatss Regulatloo ; People Helping People Build a Safer World""; HOME IMPROVEMENT CONTRACTOR Co Registration: 121,845 Type: CODECOUNCIC Expiration: 8/2 14 Individual 7i. MEMBER RICHARD TUPPER Richard Tupper Tupper Construction RICHARD TUPPER 29 Roberta Olive Building Safety Professional W.YARMOUTH.AAA 02613 Undersecretary Member#: 8158119 Exp: 4/30/2014 . ." 5/21/20011 6:05 Am FROM: Fax Duff! Carstruct:oo TO: 503-790-6230 PAGE: 002 OF 0102 1' Burly Cons u ion > Y ng Dectian Budding& si�i Phone:5DE-4?0-9334 Nlarstansmius.!Xk e-mail: Dufyconlo-@aol.com May 21, 2003 To Barnstable Building Dept Jason Silva Re 125 Winding Cove Rd Marstons Mills This is to request a final Inspection on a garage at the above address. The homeowner is providing garage doors and installation. If there is any questions please call my office. Thank You Brian Duffy Duffy Construction STABLE, MASSt.r.-HUSFUS BUILDING PERIV ,4 • °' - ___ 19 PERMIT NO. CANT _— _--. ADDRESS (NO.) (STREET) (CONTR'S LICE. PERMIT TO NUMBER OF __) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSEO USE) AT (LOCATION) ZONING DISTRICT (N0.) � (STREET) BETWEEN AND (CROSS STr:ET) (CROSS STREET) SUBDIVISION LOT _ LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI- TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR - VOLUME ESTIMATED COST $ FEEMIT (CUBIC/SQUARE FEET; OWNER BUILDING DEPT. ADDRESS BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY C SPERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE A PROVED BY THE JURISDICTION. STREET OF'. ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINE FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIOI OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR D FOR R ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED ELECTRICAL, -PLUM A I. FOUNCIATiONS OR FOOTINGS. MADE. WHERE h CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATBEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CAR® SO IT IS VISIBLE FROM STREET _— BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS '�'_cx _ z2 ---- — Qk P.Qc� • Z d0 HEATING INSPECTION APPROVALS ENG EERING EPARTMENT I_ D, OTHER — BOARD OF HEALTH WORK SHALL NOT PROCELD UNI II. THL INSPEC F PERMIT '1.'L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN TOR HAS APPROVED I'HE VARIOULIS SIIAGCS OF O K IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITI CONSTRUCTION. PERMIT iS ISSUED AS NOTED ABOVE. N011FICA110N. l.tS�'�'#�� `, 1N`r� .tk'4`��k� f�� ' :•, to T�`� °Q�''�;��si��s�f'rk "ffj� i7�i�wF�._ ' _+�,;�, ` TOWN OF BARNSTABLE 32446 .Permit No. . q BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ML II �y/y p` R,A �O mar►+ HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Joseph Bartoloni Address lot #73 125 Winding Cove Road, Marstons Mills t 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. June 8 89 ........................... 19................. ..................... .... . ..... ......... Build; g Inspector i LoT .74 LOT 72 L O T 73 24 Z 77± Ci C x I s--f 1►,4 rr t=o 216 r�-r 10 rJ 56 t �- _ / 7a. U0 COVE PREPARED FOR M IN Ul LT Y 1-10 M .5 I N G . C'ER TIF/E"D PL D T PL AN LOCATION.- MAR5-T'ON5 T-111-L.5 MA_. SCALE:=DATE //Z/6 /88 REFERENCE LOT 7-3 P�1N OF P. B. 2-7.L P. 2-9 u,i`•9 f` E'�E?ETT H.L.C.P. _ ,S ,t FLOOD ZONE: �- HI�;I'KIEY OP. .p 1787. O / HEREBY CERTIFY THAT THE BUIL DING SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON, AND THAT IT DES CONFORM TO THE ZONING BY-LAWS OF THE TOWN OF BAP,W5TP.Bt—r— WHEN CONSTRUCTED. LOW dt WEL L ER INC. 7/4 MAIN STREET YARMOUTH, MASS. D £ i (tF • J � IlJ• � �--r 7a- ' Y i � ! i " � tin „1� � i � !.; / ��! I J�/ �- • `1 77 PRc + '"7 5,4- G L4 Aj Al 7 � 0 88. O o - 3o'S.3 • _ Zs,O off. � A = 439• - A _ //y• oo - da.G E � 00 o yo. S'( 3o.ss 0 74 ,gyp�0 7.3 0 `'� 30, /98 S. o \ N ti s.,t- o N o' 43, 45/ -sue P —a �o 0 Al 2S'4 4 '/7 "J-V 1 h O I/Q �pU 72 1-4 4 0.00 '00 ! Pn 60 �� N 0 AV rim o 7/ 29906 o s ,r. `� ) 263,73 i \ 23, 1 a,7 s,F- o 0 0 4 o o 2 yv �- 20. 00 1 0 sz- � lu 6 2 Ion o I *l A ) W. PJt:IkR.y. l,iC''k ro•1' n5'. T.^iwS't of � :r.,' ;.r��•,- ,.�. ii t. '`tdiy] t. f,+� .ar.r�rn�•;,S it ,.'Y ' oJi ij]!i :.i•.;I:JCt. -------...... PLAN of LA /V o MAtySTONS BARIVS7--A OLE MASS. M/LLS ' F�R fr OLD FROST L.4N 0 I NG "yU' (A L ]"vBY J Al. ` 60 f CNECKEO BY OA TE ^-JAY 7, 1973 C1-1A RL ES /N• RFC/S 'Elva/'AV EERS SUA?VEYORS 1•/YAA/N/S MAss. i d t A '. 1 j ,I ? "T>•...�... .4* - ...tq9 w °.kt. yr �aYi"'t. mp s ^-'1�... � .m •`ua: ,.-L .:� "'ta "Y�` .�r;� ;y.:. iF. rr:. is i,�'v a �r`x' .�. � `�"•� °lr- '"Y,t-t:,? .3•. 't.,:! .hr.'.. R L:•��'-., F .?£-. .:tvS' -n ..7.+ ='tC'�-, i. nxt. -'# 2% b t•, Sr, .'�i`o?•..`�"F'�.. 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'rs k?:,rf�^ r, a� -}`- 4.s r�` 'yKn �• . ,;Y. .c' �:li � �;' ��. ?. -'�..�:• ,�• 'r�-'.�• x..l"f"..- s4i'� ,,L.v�. s.t y. �'' r4r" 7-. B 'Y if�+ :7e"4��r".L. era, E-^ �Y.+� y... ,��;�aY3s.+:;. ��':.._.1'`u��•GG:'G i ,y+''t h.ti:s;�`.r�aY•;a .,,�.�� t!: 4 ',!'.'.;ri-� ��:,. �..+s`m.n'�.• ••2*,_..r� v..-A�.'.�,-e`-�,,6<' wi-,r.s •c,e-=`�,.-.,,,� ,.�::!t__r'y�?.�:WK?+.,a. :-.� ,�:4c• r t'.+... -..s�.:..i}'G. _� :41 A C T -5 — 8 8 WED 1 3 e 47 NASH , .M 0 N A H A N & M c N U L T Y P 0 2 . NASH, MONAHAN & McNULTY (A PARTNERSHIP INCLUDING A I PROFESSIONAL CORPORATION) THOMAS V. NASH(191Q-1932) ATTORNEYS AT LAW CLAYTON W. NASH(1923.1981) 4 PEAR(_STREET HAROLD B.NASH PC, PE BOX RE 638 WILLIARICHA D C.MONAHAN DEDHAM, MA 02026.0806 WILLfAM J.MCNULTY,JR. '. MARY ELLEN KELLY «-- GERALD F. MULDOON CLARE V.NASH (617)328.0933 of 60UNSEL' October 5, 1988 Mr. Bert Emond McNulty Homes, Inc. P. O.Box 556 No. Pembroke, MA 02359 Re: Bartoloni - Lot 73 Winding Cove Road; Marston. .Miils,.' Barnstable, MA Dear Bert: On May 4, 1983 I spoke with Mr. Daluz concerning the cap-- tioned lot. The lot was held in common ownership with other lots until October 31, 1979 when it was. conveyed by New England Investors, Inc. to Robert D. and Catherine Lee -Kyle - (copy of deed from my file is enclosed) . My abstract of title indicates that the Kyles owned no .land adjoining Lot 73. The subdivision plan was endorsed and recorded in 1973, the later date being June 18 , 1973. The seven year zoning freeze expired on June 18, 1980, at which time the Kyles owned a legal but non-conforming lot. They conveyed it to Bartoloni on May 11, 1983. (Copy enclosed) . Mr; Daluz reviewed those facts with me and assuming the facts to be as 1 stated, agreed that the lot enjoyed non-conforming status. This information should entitle you to a permit. Any problems, call me. Very truly yours, William J. McNulty, Jr. WJM:CT Enc. Assesegr's office (1st floor): c�cTPlkq MUST BE THE Assessor's' map and lot number .7* a /....- •� '"` q "E Board of Health (3rd floor): p w.a7 i) Sewage Permit number .... .................CCs . ..... IT/4L CODE . 1236HD9Y1►DLE, � Engineering Department (3rd floor): TOWN REGULATIONS '°o IA39• House number .........................X .�.2.. ..................... ''�FaNOlk* Definitive Plan Approved by Plonnin�tgard _______________________________19________ APPLICATIONS. PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. 4?.E.1c.7...:....s �.G �:�...tl�t l f L fir'... E�L- N G ...... ........ TYPE OF CONSTRUCTION ..... ...... ., ................................. �T� �rZ.......3_..19.8 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin information: +LDS I 1 t� �2s ro Location �� .� pl to 6...COt�........ .............................................t .............................. ............................. ....... .. ProposedUse �P.V%I: 1. . ?...................................................................... ......................... /K� Zoning District .................Fire District /� /f� ................X. Name of Owner �TO...-D./.Q...I........Address,JQIEW..� k .. .,t...f.I.)NJ C�.�'�! M. r Name of Builder � .. Q ......Address ��..° c IV or r13�KG1'. Aer.... .,....... r Nameof Architect ..................................................................Address ...............................................:.................................... Number of Rooms ............. .. ..............................................Foundation !.OPRI ..p... .............. .. �1 ..........RoofingExterior :..0- �. ...I. 5 µ..!IZ pl: +A . P H.g.LT..S.�.J1� Sv V .... ��OQ'Interior ..I.�. .Lir'r� �... ...5 ► YY1 COAT....... Floors " ( ...�.. .....1-.... ....... .. ..... ..... 1 Heoting1-'PJZ0—V... 0..T?:i.I I5.Y...0.0. .........Plumbing ...........:. 3'T.......� ................................................... � v � Fireplace YES.` ( g 1471 ........Approximate Cost ,.J 5 0.Cr0 Area -r-27 s /> . Diagram of Lot and Building with Dimensions Fee /�� 7S ©A40 • i OCCUPANCY PERMITS REQUIREC r )R NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam/.. . . .....A ........ . . ..................................... Construction Supervisor's License .Qp..`� 7.7 BARTOLONI , JOSEPH .No ...3.244h. Permit for ...B.uild...One., Story .......... ingle...Family..DWelying....... Location ..Lot...#73,,.......1 Z5...Wind.ing....Qove Road ..............Ma.rstons...Mi,l l.s.................. ......... Owner ....Joseph. Barto.lon.i„.................. Type of Construction ....F'.>r affi.e......................... .......................................................................... a. Plot ............................ Lot ................................ Permit Granted .... November 16 , 19 88 Date of Inspection �` ........19 ....................... .. Date Complet d ...19 f c n. THE Assessor's office, (1st floor): m j Assessor's map- and lot nuber ........D`..... Board of Health (3rd floor): Sewage Permit number ...4 � j /9 . .............................:.............• Z BLB39TLBLE. Engineering. Department (3rd floor): , �o �b3e 1639 e� House number °..#. ...` ..,..�.................. CEO YPY a` Definitive Plan Approved by Planning Board _____________________________19 V APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN 'OF BARNSTABLE BUILDING INSPECTOR TU11—D - Stty 6LL I_4� IL`� �WELL.i t, G 1P�1lCATION FOR PERMIT TO ..........................................................-.................................................................... TYPE OF CONSTRUCTION l�oc>D . r-` '�� ®IV—M ............................................ .......�.................................................................... 8 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin, of rmatior�: l� ► L C.S /�,Y�-KGS 1 t�1J I Location ..... :V .. . �....�U..t\? ).1V.........c::.............................. �. .........! c'............................... Proposed Use i .�.—) ..l ........................�..... .. ............../..... lU�/. G //. ` / Zoning District �`'...� .�..........................................Fire District �( ./ ��`1 / it'Nome of Owner .. .........Address-DPEvj! T+r/}?.� Ig P. ... aln � S ij..)C . �C 55(, v Name of Builder ................... ....�.......,................Address .................. ................................................................... Nameof Architect ..................................................................Address ......t..:.......................................................................... Number of Rooms .............. ..............................................Foundation lbw:,,'�.t�... ..UtU G�k-,`fT . .................................................. �� . S. As P H 0T S eL 3 a_ H )N L E� Exterior .... .... ........'......�......................'......... '... .................Roofing Floors So CID ,_ h U1-�Gc� fit ✓ fo L,UFO-Z iz? ��{e ara'1 COra"J� r'....................... .Interior .....T1 LC ...................-.............`I............................................................ rieatingFG��j7.. t�F11..1' .t....�....O.........P....i.a .........Plumbing ...... r � Fireplace L.J ?.'.�.. ........Approximate Cost ....�. .l... ........................................ Area .......................................... Diagram of Lot and Building with Dimensions Fee J ' I OCCUPANCY PERMITS REQUIRED r0R NEW DWELLINGS I hereby agree to -conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name / ....t!//' � L�- ................ Construction Supervisor's License ��.�"�. �... 9 BARTOLONI, JOSEPH A=057-048 324,46... Permit for One Story........ No ............... ...........'i........... .........Sin.5le F.aMi.ly..Dwellin ..... Location ...L.o.t...#.7.3.f...... W� qing..Co ve Rd. ...............I...Ma.rs.ton.s...Mills........................ Owner ...partoloni , . ........................................ Type of Construction .....Frame ..................................... ............................................................................... Plot ............................ Lot ................................. Permit Granted ....]Novembe.r...1.6.......19 88 ............... Date of Inspection .....................................19 Date Completed ......................................19 Cd e,P /00/y, o— TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map , Parcel Permit# 6, 7 Health Division '� q—«C� $�- Date Issued /� O Conservation Division S �a Application Fee Tax Collector Permit Fee Treasurer SEPTIC SYSTEM MUST BE � Planning Dept. INSTAII.ED IN COMPLIANC Date Definitive Plan Approved by Planning Board WTfl TITLE a f ENVIROKINENTAL CODE ANG Historic-OKH Preservation/Hyannis TOWN REGULA,IIONS Project Street Address r �..� r • oe�k,t& ' RA Village XnnL:r-� t r1')S Owner lAeffir-n Address t f ;✓� i �' t 1 , Telephone :ao Permit Request 6Y-1,(� 1`9 Square feet: 1 st floor: existingproposed 2nd floor: existing proposed Total new`L` > Zoning District Flood Plain Groundwater Overlay Project Valuation Q?31 Construction Type Lot Size �" ,5r0 Grandfathered: El Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family B- Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑,N ' On Old King's Highway: O Yes O-No-' Basement Type: fill ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing t �-- new Half:existing t 1— new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑'Gas ❑Oil ❑ Electric ❑Other Central Air: M es ❑No Fireplaces: Existing 6 New Existing wood/coal stove: 0 Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Galexisting Wew size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes C-fdo If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Y- ((r A Telephone Number � �) !�41AO C% Q/V Address License# � ��r, ZfAm� ��i k 0 0'K � .w y Home Improvement Contractor# 1 - 4 y �� -mil Worker's Compensation# q� X/ 1/7 � ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PEi&PT NO. - , r DATE ISSUED - MAP/PARCEU NO.r ADDRESS' l� r J — VILLAGE OWNER DATE OF,JNSPECTION: FOUNDATION - FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGY.; t FINAL r GAS: ROUGq! H t FINAL' - FINAL BUILDING CJ DATE'CLOSED OUT' fib ASSOCIATION PLAN'NO. 1 i _ e The Town of Barnstable aAR�srA e. Department of HealthrSafety and Environmental Services NASS:'S' a' p�Eo Mpy Building Division 367 Main Street,'Hyannis, MA 02601 i � y Office: 508-862-4038' Fax: 508-790-6230 y c PLAN REVIEW Ow • /7 F��FF/LO� Map/Parcel: G57 4 Owner: Project Address: ��s �JiX�� ''� ��'AN Builder: 15114/6W • The following items were noted on reviewing: 145-1-/t/1S/Vi4 Z) �/2/I-DE — %TqL P 1 Hrr. r � i I r Reviewed by<�;O— e Date: �G///lJZ- q:building:forms:review t The Commonwealth of Massachusetts • w _ — Department of Industrial Accidents OIfiCC 91//JYBS1/0e1/0/IS 600 Washington Street -= Boston,Mass. 02111 3 Workers' Com ensation Insurance Affidavit name• -- �°.............location• � �l.l � � _ �/`�� p i C + �� g, �+-- �,/ " city �C�t�� TZ?i/L A t I( I 1 s� Dhone# ❑ I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one worlds in ca acsty din workers' co ensatiori for my employees working on this job. i iJ.}.,<>..>:f;:r:•':.•,>:..;r.:;::?,:: :::::: ::.; am an e 1 r rove g ...:n.::::n.:.::::.::..>mp p..... ... ....... 44 .. �n............: :. ...................... .. •J}: -' :v:n•:.:-.i:':: :ni�ti::.�:<titi}ii:i':[Y:i: ..nm:...:..-v:x...........n.v.v::,v. .....n•.....n..x.r.......-�)::--.v::w:::n..n:w:,, n...n.....:.:. : .. ...... .... ... ...{...v.., "'•n t .. .:;::: . . ... ..::::::::.:....... ...... .. .... ... .......:.v:•nv:i .... - y .................. J: �s i:�'' '-:`�`r.':i•.>'�iY.�":Cif:•: :i::?-:v.'�ikj'v: ............. •Ci: :::).:Cy'`: %:.:':jjL;OJY':•?:{}::i::+'j":::iF:.}}::: �11.911T8n ❑ I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following ' compensation olices: work `'. an'. `'cries <� C.., Y. esa. r v::::.v:::::.:.v:::n::.:.:::::::::.v:.::::::::. r::r.:.::•.v.v:r:CCCy�v::;nv:• CC•ii:•ir:•i:)):4: J:[C•:4i:ii:•Yi:'•::'i>?:'r:+vi?:t4:<:i:•Y:.�ii'l.±ii:;:;:j;i:;:nt.2?�i:y!;: nyC:;3:::}}:y. ............. .}'v}}:•r:CC!i}i:•'i.::.y:.)'::^i:C':.:::.w::r.•.:4JJ:}i}::4i}):4';4::•}}J:4?::f;i vC:;4::•}•::{f•ii:5-.}:}....v.: .n• r.... i;:;}.'•}t .. 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JJ��.. ...v...............• ::/r:::v:!:i: �iii::ii} ynyv::.}::::v::::v::v:••::::.......:::�?:•}i)i?:Y::t•?:•:. i::::j%:}:i::>.'f'Ji}:;Y:i+:::::i:':::i:::+:::<}:}::�y:tiv�ii�;:i•.?n�::..n:viJ';4:�n'4':t::t::nY::;:4?'.y............... 1U11Ta1lCC?C0�i';'<',S�<�'fr?:..+.;:;;:-}:.;_,.;2;v,.y.-.t<:,:..:...::...:... .:':n..:.?•-„.;.:::::- Failm a to secure coverage required under Section 25A of MGL 152 cart lead to the imposition of ctitttit�al penalties of a fine up to$1,500.00 and/or one years'Imprisonment as well as dvfi penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day agatut me. I understand that a copy of this statement may be forwarded to the Office of Ltvestigations of the DIA for coverage verification. I do hereby c th sins d penalties of perjury that the information provided above is trap and correct r Date signature may_ PhonePrint name name official use only do not write in this area to be completed by city or town official permit/license# ❑Bulldog Department city or town: ❑Licensing Board ❑selectrnen's Office ❑checkif immediate response is required ❑gealth Department contact per-son: phone#; 00the! Oevued 9/95 KA) 1 1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more 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 of other legal entity, employing employees., However.the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the 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. � - r MGL chapter 152 section 25 also states'that every state orlocal 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,neither the commonWealtl 'nor any of its political subdivisions,shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter`have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits 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 obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns 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 periiuf/license number used a which will be s a reference number. The affidavits may be returned tr the Departmei by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to,give us a call. The Department's address;telephone and fax number: t , The Commonwealth Of Massachusetts Department of Industrial Accidents oMce of lovestigsUons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 r - 0 FZHE T Town of Barnstable Regulatory Services r • BMWSCABLE. ' Thomas F.Geiler,Director MASS 039..E N. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: rl e4-!' " Estimated Cost - (_ Address of Work: gel 4k)" Owner's Name: i� Date of Application: Q I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES 0 Y I hereby apply for a permit as the agent of the o r: iDate v Contractor Name I Registration No. OR Date Owner's Name Q:forms:homeaffidav t f, _ �a �OAF7b t)�BUILD1Nt�REGUIJ\TtQH3 � Lid6i" CONSTRUCTION SUPERVISOR _ 4. NWnMt CS`, 49152f Enpini p4flW003 Trcoo iso 10260 BRtAN PI DtlFPY `` 133 FkEETWOOD BATH I r G�«.+ � ✓` { - MARSTONS MILLS,'MA 02548 Administrator : � STiwN, �di�•�'4 .i++�•wa'w1 - M•11✓+iyF+ Y4'�Mwrw�(-:\ • # 127246 Date Ex. 09/27/02 Brian Duffy 133 Fleetwood Path Marstons Mills, MA 02648 •� �ei �mmonanroaa�o�✓�aaduc�itee� �C`• • � ;P •"rd of Budding RtgWations and 5tandur3s �'� •gym ^t allJ�i .riv+du HOME IYPROH=MEWr C MMACiTOR , :c t •i•Y.lut •1tC. U ..nd rlh r7 tW r R � 127245• ° 2 P .atior "�-' i• type: i DWIDUAL t _ 61"i D;JFFY ' !•OUFFY .r!n �--- ste,A"omr'R MIst1S,AM 028Y9 Admirist,ntor .r • i . N iV.4 a rr 4} wtir. Y. .::<:]:�:...::^:.>.:: �.,.,._.,:..�via..,2,-.M.. �x::-:::: 4reti�t� :':•i`i^. .i.::::.:.}::::'''.::izyt..:::t<�::::<.,5i_CE:L.'EC.:sGiT.,.':T`: ..~•t. :fix#. - ,.iy: > t*y. r ..:•,.:...::...... ,...r,. .r....r:..,:. aa....,,mot,-'I.YS.�:„�;,: ,e:��':s.....,. ,.r,v-err,.. - ........n....- ,fix � •a,Y'<. .:.t- __S.fY'::.5' -%�7�c'�:`. 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