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Home My WebLink About0141 WINDING COVE ROAD 14( WIAIDIM6 i4 r. a �Im Town of Barnstable Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept MAS& Posted Until Final Inspection Has Been Made. Permit 39. Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-1683 Applicant Name: BRIAN DENNISON Approvals Date Issued: 07/02/2020 Current Use: Structure - Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 01/02/2021 Foundation: Location: 141 WINDING COVE ROAD,MARSTONS MILLS Map/Lot: 057-049 Zoning District: RF Sheathing:me: Owner on Record: FEDELE,SUSAN M TR Contractor Na SOUTHERN NEW ENGLAND Framing: 1 Address: 141 WINDING COVE ROAD WIDOWS LLC 2 MARSTONS MILLS, MA 02648 Contractor License: 173245 � Chimney: Description: INSTALL( 2 ) REPLACEMENT PATIO DOORS NO STRUCTURAL Est. Project Cost: $21,562.00 Permit Fee: $ 109.97 Insulation: Project Review Req: / Fee Paid: $ 109.97 Final: Date:/ 7/2/2020 1' Plumbing/Gas ��...�i.K� Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and thelapproved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department V_ Building plans are to be available on site Final: c� All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Assessor's map and lot number .. ?..�1..r...'1��........... ..��. oK .3 B,C, .SEKIC SYS�`al �'�ri:�.St':° f�Hero�o Sewage Permit number ......... ../......� .................... INSTALLED IN COiVI .t I' House number WITH TITLE 5 : B9BMAO& E, rasa I .T...� ENVIRONMENTAL CODE AID°° 'b'°• 0� t 6t -7 �" TOWN P;:r R ��T10#�S �o ypY M\ TOWN OF BARNSTABLE BUILDING INSPECTOR ff �- APPLICATION FOR PERMIT TO ............l........ � .... ...................................................................... 4 TYPE OF CONSTRUCTION .....W. ........................................................................................................ . - ...r..�........................1 .I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accordi to the following information: .. ........ .. 1 s....................................................... Location .............0—A�- - ..... . ProposedUse ............ ............ ... .................. ... .................................. ..................................... :?Ilq Zoning District ......................(`-/..........................................Fire District ............... ... �.� Name of Owner ............. .... .. ....... �.. .. .............Address ....... ... ...... . . ...Cc�^—e.... ....... . . Name of Builder ..`...V..... . ...Z. ................Address ....IN. .... <-. ..... .4. .1.. ......................... Nameof Architect .............VU. ........................Address .................................................................................... Number of Rooms .........(......................................................Foundation ........4............. . .... e...................... Exierior ......... ...............................................Roofing .... .. .. . ... ...... ............................................... Floors .......... ........................................Interior ............ . ........ ............................................ Heating ..................................................................................Plumbing ............................._ Fireplace ..................................................................................Approximate. Cost ..... /.....Q............................. Definitive Plan Approved by Planning Board -----------_______-----------19____ _. Area ... 0... . ....................... Diagram of Lot and Building with Dimensions Fee G!..Jr.. . ..................... SUBJECT TO APPROVAL OF BOARD OF HEA 1 I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 I hereby agree to conform to all the Rules and Regulations f e T w f Bar ab re in, the above construction. Name .. .... ... ............................. Construction Supervisor's License �o � FEDELE,-,STEVEN . Remodel Garage, No ..28.000 Permit for .................................... to Family RoomZp.�jil-d...Q.ar.a.ge- .......................................... ... Location ...CO.Ve...Fwa-d....... Marstons Mills ................................................................................ Owner ....Steven Fedele ................:11-1--l-11............................. Type of Construction ......Er.(AMe........................ .............................................................................. Plot ............................. Lot ............ ................... Permit Granted .....J.0.ne....10.................19 85 Date of Inspection ....................................19 Date Completed ........... 19 14) ' Assessor's map and lot number .4 .� -Y.7.....o11 K:��{�• of ro THE Sewage Permit number ......... ................................ O Z BABBST(iDLE, j House number ............................ .. ................................. 9�O M6 9 e� Y --7 YPY Or TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................................................ Q .......................................................... TYPEOF CONSTRUCTION ....( ....1. ......................... .............................................................................. I ...........................................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: / r/ / wi ........................................................ Location ............ �..� !f. ...5. �71 ..........;... �....................y.l...* ProposedUse L........................................ .............................................................. Zoning District ......................1�- .!..........................................Fire District ............... ....(.!................................... Name of Owner e.V-O.. ................. ......................... ......fin _... f �./� 4�-r� Y r f I Name of Builder \� ..._.. .t../` ..........Address .... ............... .......... . :......................... ......1.......`.�......`........ ,. .... 4'.. ........... Name of Architect ............'!�-�'.. ........................Address .................................................................................... iI Numberof Rooms ........./........................................................Foundation ........ C .��..9 -Q....................... ........................... a*. Exterior ........� P_.......................:..........................Roofing .... n ............................................... Floors �!....... : ,.............................................Interior ........ D�.e .., .::............................................ Heating .......................Plumbing .............................. .............:..................................... Fireplace ..................................................................................Approximate. Cost ...................... .. .......... .............................. Definitive Plan Approved by Planning Board ---------------------------------19___ Area ...�; ...zfi:................... Diagram of Lot and Building with Dimensions Fee ....1,.!..Sa. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 1 f a • � r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town.of Bar,s'table regard ng the above construction. Name1... .... ...................................... 000 Construction Supervisor's License ........................... . FEDELE, STEVEN A=57-49 No ... Permit for ....RPAQdel...Gar-age ......to...F ami 1 V...RopRVB.Ujjd...Gara . ..... .... .. ....— ga Location ...14.1...WiTidiag...Cave...Road..... .................. aiArl, ..Nei ........................ Owner ........Steven t...e.....ve...n.....F...e.....de.le.................I............. Type of Construction .......Frame ...................... ............................................................................... Plot ............................ Lot ................................ June 10, 85 Permit Granted ........................................19 Date of Inspection .....................................19 Date- Com pl6ted ......................................19 I p CURVE TABLE 0 o of CURVE LENGTH RADIUS p ^o. C1 20.00 370.00 �� rn N W U 7 4 Q N / N Y O O m . Z I Q J I 0_ CD � II11 73 � � oo 00 00 O I - .N N 2�1•�� L O T 7 2 O o / 27,755 SF Id (per record plan) 0 � ADDITION W/DECK PROPOSED NEW CONSTRUCTION 00 �r— 24' x 24' GARAGE 0, f� �. O o o t9, o o ` Z 5� ..; � o 69 ry , .- S • � <q NN •O. 0� Ilk . S �6• L 7 1 = 70 09 60ti R _ 50.p0 c I)�.. tee ASSESSORS MAP 57 PARCEL 49 e F" CERTIFIED PLOT PLAN DENOTES CB/DH FOUND 141 WINDING COVE ROAD I CERTIFY THAT THE EXISTING STRUCTURE AND LOCATION: MARSTONS MILLS, MA. PROPOSED ADDITION SHOWN HEREON COMPLIES WITH THE SIDELINE AND SETBACK SCALE: 1" = 40' DATE: 07-08-1999 REQUIREMENTS OF THE TOWN OF BARNSTABLE AND IS NOT LOCATED IN THE FLO DPLAIN. PLAN REFERENCE:PLBK 272 PGS 29-30 DATE: -1-�-c1.9 =F�n j I BAXTER & NYE, INC. THIS PLAN IS �OT BASED ON AN REGISTERED LAND SURVEYORS ' INSTRUMENT SURVEI�AI�D THE OFFSETS & CIVIL ENGINEERS SHOWN HEREON SHOULD NOT BE 812 MAIN STREET USED TO DETERMINE PROPERTY-LINES. OSTERVILLE, MASS., 02655 APPLICANT: STEVEN R. FEDELE, ET LIX. 99060 (CPP0I.DWG) Assessor's map and, lot number/:'.-. OF f N E t0 Sewage Permit number ........................................................... ` ` e Z BAUSTLELE, • • House number �f � f 9� NAM p 1639 �0 UR a\ TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .........:�!?�A-) fi i Ic';,; TYPE OF CONSTRUCTION ......... ?. ; P �. ;I.." 4 !. ?.... a11 !, /"' ( i ......................... I y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby .a.pplies for a permit according to the- following information: Location �F......... ....... x�� 'c l)!(�JC�� / �= 1 c '� b�A t �� "t A ..... ...... .l ......... .................. ......... . ............................ ProposedUse e-1.... TA. ......................................................................................................................:. ZoningDistrict ..............:_..�...: r......................................Fire District .......... ."i ,a. ................................................ Nameof Owner .............. .........,..;..............4..,.. ,(....Address ...:..:. ,.,.................... Nameof Builder ... ..:,,..,.;.A.. .... .................... ...............:............................................... Nameof Architect ..................� .............................Address ................:,5 ..................................................... Number of Rooms .................... .......... ..................................Foundation u` lf)AJ 1 #1d�laC' .4. .................... .......................... Exterior �.�LADb04 �„��,��?I►?��1 � Roofing ......... �� —a�II�IS�I ................ Y ......... ....�. r............ Y ........................... ......................�....... � 1 :r'- ' .Interior - 9kJ ........................................ Floors ................,...�.. .................p................................ ............. ................ Heating . ^?^J � y ...� /Q7� �{ g ��171 �.i(� ... .. .V.:L....... Y....... ,,t.. . ....................Plumbin .............. ...... . Fireplace . ..........................................Approximate Cost.............. ............................... - ----- 19 ----. Area -,' w Definitive Plan Approved by Planning Board _____________________ _: ..................... .. ......._.. Diagram of Lot and Building with Dimensions N Fee .`......... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... .....��................ uugarlaod, Pete," �&=5?-49 ' . / � No _21�9g_ perm°for __l..I/2.'gtp��_.� ! --'�'� — --� �� ' � single family dweI ------------'------~^------'' ` Location __.l4l..Wiud' .......... / Marotoua Mills,` i --------------'="�`�' -------- . P ' � �^�^� v / / )SrAtme...................... / ',- of Construction_ ....... ' ................................ .........../.................................. ' . . .". � �� ( ' ' ` ` | ' | ` r�,mv Granted" i � ! ""'=~^' ""p=`= "`` ' . Do/a Completed ' ) ' > | ` ' � PERMIT ' __. —. lV / ~ ..................................... . —.-----~..—`— --------.---� . ^ . --------'--'�—~'----~''—'----- i � ----.----.~....-----..------.— � Approved ! � ---------------- lQ ' --------'--------------^—'-- . ' � > ---------------------...—...— ' � s map and lot number 7 r 7 ! " `� �C � THE tp� SEPTIC SYSTEM MUST @- e Permit number ............................................:........... _ Y BaaaszenLs S l Se, / INSTALLED I�� COf�iP��r ` use number ........................................................................ ^�Y �p MAG& TOWN OF BARNSTABLE � BUILDING INSPECTOR APPLICATION'FOR PERMIT TO ....... .....t` w..16.(.—9. ........... ........................... TYPE OF CONSTRUCTION .........ty?.f � -} �.�� W!t�..5 ....G-19 .C.,.................... A-1 ...I....................,9.. . * 7+J lHt*lr��',: P-OF BUJUQINGS:- The undersigned hereby applies for a permit according to the following information: information: Location' ." ........ .� �: ... r .. l......!.1 .... 1..� ..�.. ................ ProposedUse ....... .��: ' ,............................................................................................................................. ' s .. Z- �CF' .1 Zoning District ............ :. ........................................Fire District ........... ` '......................................... Name of Owner ............ ...v.N! LfT^!. ....Address .T.i.4.. Name of Builder .... JAL ..Address ............................... Name of Architect ...................�"l.T1"tE............................Address .................:5 . a�................................................ Number of Rooms Cam........................................Foundation L�.... Ou. .... . ' Exterior ........ h!' �.�}C9!'...N. S ..Roofing .........4-?.p.Xl.. .. .�1'i� '��.t.................. Floors ................OAapor............................................Interior ?Ohwl Heating 3. Atag.. ....Ct�4....� q A.L.......Plumbing ! O. .Y... s......................... A. `� . Fireplace ................... ...........�..........................................Approximate Cost .............42,10vo,............................ .. Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ................... Diagram of Lot and Building with Dimensions Fee ....................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH ,3 -`s 3J LY 1 t 5/- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....OIKO--i. ... . ... ............. C ngeriand, Peter T J * .... Permit for ....................................1 1 12 s tor y single family dwelling ................................................................................ Location .........141..Winding..Cove...Road........... . .. .. . ........ .. ...... . ...... . Marstons Mills ............................................................................... Peter Ungerland Owner .................................................... ........... .� � �• .+ -� �, frame Type of Construction .......................................... ............... ................................................................ Plot ....... .................. Lot .......... 2................ J Permit Granted ........April. 18 79 ....... ......... .......19 7 Date of Inspection ..... ......... 19 Date Completed /;2.:.3................. 190 PERMIT REFUSED ............................................................ �Iq -7, ............................................................................... ............................................................:1................... _e ....................e............................................................ ................................................................ Approved ................................................: 19 ............................................................................... ..................... 16-/Z "OW A G1 � I + � ram. P•eoR 2y Aj ' �30 ov • �VuCltDfUGUC OL 1ti,?ana8 ' tq��r��` CEC'i 1FIl�L7 p�o'r PL•.l�,w 4p Suf+'� LbCIsTIo� �Iem�'S f GGRTIt^�{ Tt4A'r T(-AC �OUIJzOnop 5t-1Ow" �ti'Q`tJ �`�FE�CNLE NEQ Ea�,1 GvMPL�(s WIT" TOG LT -Z A>Ja SC=TL3AGIG �.'C-QUI�ErVt�+-tTS of TNC: 7ow►.,d IG A QIJ/7T1a VLz �'m �—AtJDt u L s DATE BQ'rCTCIZ � uYE_ I�•IG. t2C.Gle.; IL-IZ%.D LA.Wo SUL'V�=YotZS Yi-lIS l7LAl-i IS �tOT t3A'S(cY7 v�l AOJ____ _ -- V �toa-v-%L-i G _o �1��tlL�S• - $<i�;t` t7��i�►:1; �SU�;vt=�{- 'T:3G Ut=c�;�T'S •itlt�!�t.D ;I:;,pt_IC.A1�1T- ! 1 1' F�L= t��t^t� 1v Di�i'Cl_Attwll LOT '► TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map d ParcelAR Permit# Health Division •�'�� J 3 � � � � Date Jssued g Conservation Division y? Fe 310.D U C Tax Collectorow% Treasurer I SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH J�j fA Preservation/Hyannis ty ` R Project Street Address , Village Owner -f-5.cA6141V�, Address Telephone Permit Request �fn� ! rF� E" - CA e Square feet: 1st floor: existing 16nO proposed EM 2nd floor: existing 4pa proposed Total new Estimated Project Cost I00 CQ Zoning District Flood Plain Groundwater Overlay Construction Type WO-4— m - Lot Size�T7SS S Grandfathered: ,VV es ❑No If yes, attach supporting documentation. Dwelling Type: Single Family b Two Family Cl Multi-Family(#units) Age of Existing Str ucture Historic House: ❑Yes �No On Old King's Highway: ❑Yes �No Basement Type: ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) L Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new 0 Total Room Count(not including baths): existing new c;)- First Floor Room Count Heat Type.and Fuel: ❑Gas Boil ❑ Electric ❑Other Central Air: ❑Yes X'No Fireplaces: Existing New Existing wood/coal stove: ❑Yes )(No Detached garage:❑existing ❑new size Pool:❑existing El new size Barn:❑existing ❑new size Attached garage existing ❑new size Shed:❑existing ❑new size Other: U)A/E— Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes No If yes,site plan review# Current Use Proposed Use 5Apl� BUILDER UIILDER INFORMATION Name �(�D\J0V I (b6QE� A�i--+y C_ Telephone Number `?8 2�78 Address J�� u f" License# C 1 o�� [ Home Improvement Contractor# Worker's Compensation#SC R72 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN T09,�W&J!E 1.A= SIGNATU - DATE — _ d FOR OFFICIAL USE ONLY PERMIT NO. - DATE ISSUED MAP/PARCEL NO. ADDRESS f VILLAGE OWNER DATE OF INSPECTION FOUNDATION s . FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH: r FINAL -9 `z i I n> PLUMBING: ROUGH" °� r- n FINAL GAS: ROUGHS P FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I I• are •;, - p Irm I LIB F Dew evlin C43ustom tl e p esigns d5 - _::'31'C•NS_'EL-EVATION.. teFT'E-,L w I / •, w nary plan,a luyou„by OC.D....lu n1Y—y.1-1.11 11„rltlly P-1-111 6 IcAll .... .. 14 77 508.428.6191 evl i n @ustom I Designs � tognpm O rD99 . ' Deter rDn➢ I : i� I it2. 3 6 r.rnmin,�r oi,n,anD IaroD��Dy oc.o.ue log�n a of�nel�� onlr nny o�nr.��.I..i,��iiy p,oni D��D „- - ••tl .•O' ..b Itp' _� I .C4NMT m' uan:v+ur iai. a -- --- �” � i � � -I of_ �• N — _ I I i • R —�mon Mweeup- � }' E � .iwrte <�whj ..�.FJJIlwt�.wtar-.a.'ti.w.n n.y�.r�.e•._u.wga.e:..D.:l.a.i.p a-:�-..�:._ '-lot9ae.gw.'e*bewlrn<o�o.a.uw ptaycyk.o..u.:•..i,:...I.:xrW.::..". ...._-.... �!I� 508.42r` 8O .6r D 1999 1 evlin stom esgnsD p 9Dr .00p 1e1 L+ocnnc!A ! .. � 'I2CO�6C[71�N.':fcftEIIi_Rfi4N.c��:C'�••.!o•) / ��' :: Z p W P A - Q � J AS w • i uY D eY Oc.O.m 1D my.wny a ab pra j � ' r v!'WX V NE"IMPRQVEMENT CONTRACUR r Registration Type.4i,INDIVIDUALi.;;,t`,� � � ation�'�py''03/08/00 orJ v4 lttYKog r� >RPETER,1 llLODEAU 231�.PRINCE:oVE.. G� �od6. tSTONS HILLS'MA 02648 A' a a . * �ADMINIS�AAT0�2 rT"'i�.�`s•,t�%�i'�''` ,X� ��f� � f ... - _ — •✓/ze.-Vr omvnzovw�ea`Q�.�./�aaaac�ucaetGr DEPARTMENT OF PUBLIC SAFETY CONSTRUC�f��01PtSUPERVISOR LICENSE t Ny b —.Expires: BO ,�.1�E1€fl`TBIQD�AU v`"�131 PRINCE AVE j,,+� NARSTON MILLS, NA 02648 ;wUNSUMER=INFOR O The Massachusetts State Building Code(780 CAS) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR, Appendix J, Section J1.1.2.3.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom"of any size, configuration, orientation, form of construction or percent glazing, but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list of product and design considerations that a homeowner may wish to consider before actually constructing/installing a"sunroom". It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO"SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom • Adequate ventilation-Operable-windows and fans • Applied Shading Systems • Insulation level in floors,walls,and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.1.2.3.1, requires that the actual property owner(not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the information in this document concerning sunroom comfort an energy conservation. Signature of Actual Building Owner Date Print Name Address of Permitted Project ,20L 61.21-ZA 3 7 _ Owner Address(if different than project location) Owner's telephone number �WE A • . 'Y The Town of Barnstable MAM �0� Department of Health Safety and Environmental Services &659. " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 D Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date,q - i 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: (fl K S� t�DO c} ran) ��QEAQ. &bk�Estimated Cost l coi cor—) U Address of Work: 1 41 W l Ki' A r?ST bfl) Im M I � �,� 1 " � Owner's Name:./ Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law C]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 OF PERJURY I hereby apply for a permit as the agent of the owner. < ( 560Z, 'Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav I ne LOmmonweaun • Department of Industrial Accidents VMCCo1lfiYeS998 ions ._ 600 Washington Street Boston,Mass 02111 Workers' Conivensation Insurance Affidavit z name: QC,30� o� location: 14 1 W ( ►J C(K)(2:) CDOO- ,Q city rVe-5�0� m I vhone# ❑ I am a homeowner performing all work myself~ ❑ I am a sole P.7rietor and have no one worian in acity EVEN Imam an employer•........roviding workers'compensation for my employees worlang on this job.. P....:: a <':;.}:.: :.... ...<::Y>''.>:;::<:::<::;:YY::.}>;:•;:.;:-Y:.:J>::«!;•:;;.}:;;-;}:.}:.}:.}:.:.;:.}} ...... }:}Y}:•}:.:}}}::.:}}}<::!........!....comaanv:.name:::':: .�rr }:.; ;�<:<::<:...... ...2 .................... 53: 8tlat e :..;:: ::::.:...: ..:::::...: insuranceca...: ::. : :.. .'';,:<>':<>;: . :::'...:::.;. . :: f :: :>`:>:>:<::<'::< olicv.#....:.:.::.::: .: 73.:: .......:.:............. �� l Mole�propfi�etor enerai contract or�homeo�wnercircle one)an7have hired the contractors listed below who have the following workers'compensation polices: coianv riam ..............................................::::..::...:.::.::....:......................... .............. ........................................ .::.Y:... .:::..:.....................................::::. : : rei. . ...... ..... .................... :...........: address:: :::........,: ......,........:.,...:::.:.:.::.::::.::...::.............:.:.......... . .........:::.::..:...............:........ .:::.........«..:,.......:...::::...:...:.:....,:.:,::,,..,,,.:::::,,,,:,.::::.::,.::!.:.,,.,::....,,.......<: :::.:.:..:.:.............::::..:.......:.....:..:..::::..:::.:::.:.:... :.........:....rt...............................................:......,..::._..:.:::.}-.:::.:.tr.......:r..:.............,...............:..r...............:::.K:::::.:::.:::. .::-: :..:........................... ..:............................................. ...... u... .................�....................................... :.�.:.::::.... .: shone .......... 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Y' . :> i . iv ..... ...... .i . :::::::::. .... : . : .....................i.i:.i:....:. .;i.s.j.j.::isii:;iYwi�i:?}!.•'.:i?::::j.?.1.'..`.. .:}..:. .;:..:j..$.......................... .. ....... ... . ......... : . . . . ................... . . . . .........................................,. ;•; ...: . ..... .. .. . . .� t .... ..� : . : !...., ... .. . . : ..: . . .... . .... . .. ...... .�. }:}}}:!: . - • •: . . x . ...... } . .. . 4 .. :. w ...::.::::::::: ;;;: ;: :;.........................................addr�ss : : s:ii � � ; ;f 4i . : .................................................................... »� city' ..........................5. :t•::::.....•......::::•::::::::::::::::•::•::.:::•: t,..•..:::.:.. ..................... ...t.. .......:...r ....... ....................................................................................................... . '•:':::::::'::Y:...........• T....v.n...r..x::x:.;}:x:}J.JY.': i'vi:>.:ii:}:ii�:•Y:•}}:•} nsorance'ca'Y::.}:::..:'!.:.}:.:.:::.:.::::.:.:.::.:::.�:::.:::::.::.,..::::::..::.,::..._.�::::::::.:::...::.:::..�:.::::.�::.::.:::::.::.:_:.:: olicv.#�-:'::::::::.::::::::}:.}:.;:.}:.;}:.}:�:-::..�::.�:::.�::.:.:.�:..:.::.::.�::::..:::............::::.:.�::: Failure to secure coverage as required muter Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Sae up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I ceder stand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby cert'i a Pam* ofPerlzy that the information provided above is try mtd correct Signature Date Print name - \ Phane#,-�6 42-<'P-D LF 79 C13chedLiflnunediste e only do not write in this area to be completed by city or town official wn: permit/llcense/t ❑Building Department ❑Ling Board responseis required ❑Selectmen's Office ❑Health Department erson• phone#; ❑Other (WASed 9/95 PUu 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 or,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. MGL chapter 152 section 25 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 requited. Additionally,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 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 situatim 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 member listed below. �� : ��i,��i.!i % �// ///// ��///11, 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 permit/license number which will be used as a reference number. The affidavits may be returned io the Department 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: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Imlesug8dons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 Town of Barnstable Building Department Hyannis, MA 02601 August 4, 1999 To Whom It May Concern: As the owner of 141 Winding Cove Road in Marstons Mills, I have decided to add a sun room addition to our home on the rear of the house. This area will have more glass area than the Massachusetts State Energy Requirement Permit suggests. I understand this code and want to proceed with the project. Sincerely, Steven Fedele 141 Winding Cove Road Marstons Mills, MA 02648