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0269 WINDING COVE ROAD
�'� �/ 2v Inch o Co ve � Town of BarnstableIRScEzrPT � Y NAn '"'�`•"�`� ' 200 Main Street, Hyannis MA 02601 508-862-4038 039. Application for Building Permit a ? O Application No: TB-18-228 Date Recieved: 1/24/2018 Job Location: 269 WINDING COVE ROAD, MARSTONS MILLS © cc Permit For: Building- Insulation-Residential �o Contractor's Name: Elwell H Perry, Jr. State Lic. No: CS-1040 8 -o Address: Acushnet, MA 02743 Applicant Phone: (508)99 5770 . v =rn (Home)Owner's Name: KELLEY,PAUL L& CAROLE M Phone: (508)428-2921 (Home)Owner's Address: BOX 515, MARSTONS MILLS,MA 02648 Work Description: 6 hrs. Air Sealing. Weatherstrip and sweep 3 doors. Install 12" Cellulose to 575' open attic. Make access to attic. Install exhaust hose with roof mounted flapper. Install 36 prop-r-vents. Install 2" rigid ins board to 436' common wall area. Install 8" Cellulose to 42' overhang. Remove old insulation and install 1132' of R-30 fiberglass to crawispace ceiling. Install 2" rigid ins board to 48' crawlspace ceiling. Install 10 mil poly vapor barrier to 144' ground. Total Value Of Work To Be Performed: $7,830.00 Structure Size: . 0.00 0.00 0.00 Width Depth Total Area 1 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). 1 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: Elwell Perry- ' 1/24/2018 (508)99.2-5770 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost: $7,830.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $89.93 I/24/2018 $39.93 xxxx-XXXx-X)M- Credit Card � 4419 Total Permit.Fee Paid: $89.93 v2a/2o18 :.__...._.._ .... ...._. ,.._._.. _.... _ _.__._ :..._..___..w... ... .. _ J $50;00 XXXX-XXXX-XXXX j Credit Card 4419 � ,' I a11D�5/ 35 of Toy, Town of Barnstable *Permit# ' Regulatory Services Expires 6 months&om issue date �� MRNSI!"LB, , MAM 059. X ��� Thomas F. Geiler,Director �:., 'Orf —PRESS PERMIT . Building Division Tom Perry, CBO, Building Commissioner 5 k P � t 200 Main Street,Hyannis, MA 02601 TOWN www.town.bastable.ma.us �F g�PN�TAi3L._ rn Q Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number e 7col QCpc::� Property Address a,6 uLtk � �q k 1.,Residential Value of Wor L ��5�� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 'Qr PC) Contractor's Name O 0{— TelephoneNumberos� Lf)? 0`1�1=f Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance fckone: am a sole proprietor am the Homeowner have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) X-Re-side ////// #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is required. SIGNATURE: Q:IWPFILESTORMSIbuilding permit formslEXPRESS.doc Revised 070111 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leljblv Name (Business/Organization/Individual): Address: cb , City/State/Zip:/,O 5 M([CS 0o4* phone #: 5 U Are you an employer? Check the appropriate box: p y 4. I am a general contractor and I F ype of project(required): F2.E1 I am a em to er withemployees (full and/or part-time).* have hired the sub-contractors ❑New construction I am a sole proprietor or partner- listed on the attached sheet. ❑Remodeling ship and have no employees These sub-contractors have Demolition working for me in any capacity, employees and have workers' [No workers' comp. insurance comp.insurance. 9• ❑Building addition required.] 5. We are a corporation and its 10.❑Electrical repairs or additions �Xl_l am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4),and we have no 12.�Roof repairs employees. [No workers' 13.❑ Other comp.insurance required.] 'Any applicant that checks box#1 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. $Contractors 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 the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration'page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under thepains andpenalties of perjury that the information provided above is true and correct Si afore: K Date: 2/6oh/ Phone#: 14cYR O( 130 EOther . only. Do not write in this area, to be completed by city or town official n: Permit/License# hority(circle one): Health 2. Building Department 3. City/Town Clerk 4.Electrical In umbing I::o:.son: Phone#: rV �,NE' ti Town of Barnstable Regulatory Services • MUMST mc.a. s g Thomas F. Geiler,Director i63q. �0 any' Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all'matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name I Date Q:FORMS:OWNERPERMISSIONPOOLS i �TME Town of Barnstable 11 Regulatory Services anxrtsTABLFE Thomas F. Geiler,Director tKass. 9`bp 039 •°� Building Division " Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 7 �O JOB LOCATIOM-a), ( u, rc�up k jl� numb �� street ^� village "HOMEOWNER": t) e V LOW act> ame home phone# work phon6# CURRENT MAILING ADDRESS: O J city/town state zip code The current exemption for"homeowners"was extended to include owner-occu ied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides.or intends to reside, on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building_permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and req ' nts. Q Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1.-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue.is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt 0 n`..1.6. elf— 7....:1,....:... >� � � �` �ssessor's map and lot number �� SEPTIC SYSTEM MUST BE ................:�.. 'INSTALLED IN CO��IPLIANCE a,: S-- g ".Permit number WITH ARTICLE II STATE ray, !...............:.. SANITARY CODE AND, TOWNS �Qypi?ME tO�`o Y TOWN O F BARNWRIL E j BA"iTADL Al ILI aYa�e� am BVILDIAG INSPECTOR APPLICATION FO(R PERMIT.JO .... � .. .......... �"` �.`�.. UI,JI,,....... �.. .. . 5.... ! r+ -TYPE;OF CONSTRUCTION ! ( . . . s ...........�1 ...................1'9..(....1 TO THE INSPECTOR OF BUILDINGS: �`!"�1F�`�,,'�tLl,y^wi�n�:�E' "fYY,';; ar The undersigned°herr�eby /app�l'i's or-a pperrmitt acccoorJding to�t�he follloowingg,information: Location .. .`Y.......w"" ..�.X�vf.d..q..Co'^PN.1...�.!!.""'!:��. ../....fv?. '.Y:'�....��14............ ProposedUse ..GiGw {.1 ................................................................................................................................................. ZoningDistrict ....................�t............:.............................Fire District ........................... .................................................. Name of Owner .4. .. .!... kl..... ......................Address ...�k..f......... "1 Nameof Builder .... .:.'."C................... ........................Address .................................................................................... i Name of Architect ..................................................................Address .................................................................................... • Number of Rooms .......�......................................................Foundation C`."":4................................................................ Exierior ."1�`'��.4?.......�:O�.............................................Roofing .. ' . .lX.....i.(.[. 0 ..:.............................. .... Floors ...... ..�CY��..........,.......................................................Interior ... . ..... ..�.Qa:.4................................................. Heating �22...` ........................................................................Plumbing ....e3......................................................................... Fireplace ....��,. , ................................................................Approximate Cost ..1 `.J. ...........................................1�... Definitive Plan Approved by Planning Board -------____---—-----------19________. Area ...... ...... �U Diagram of Lot and Building with Dimensions Fee ... , .....-�J...: .............. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby:agree to conform to all the Rules and Regulations of the To f Barnstable regarding the above • construction. Name ...... ............... ............................................ ............ • Kelley, Paul L. 74- ea 445 1 1/2 story No,a.................Permit for .................................... .single ngle family dwelling .. . ........ ...... . . .. ........... ...... Location ..,,,Winding. . C.o7i..Road . .... .. ...... ......... Marstons Mills ............................................................................... Owner Paul L. Kelley..... Type of Construction .....................frame..................... 7 ................................................................................ #36 Plot ............................ Lot ................................ Permit Granted .......... July 29 19 77 Date of Inspection .... ........ ...... ...... .......19 -7� .19 ..................... Date Completed PERMIT REFUSED' ...................................... ......................... 19 ................................................................................ . ........................................ ...................................... ................................................................................ ............................ ............................. 7) Approved ......................................... ...... 19 ........................................................... .................. ............................................................................... Assessor's map and lot number Q/f 7 7 7. I; Sev✓age Permit number ......................../Sw .................:....... s T"Er° TOWN OF BARNSTABLE i MiBSTAJILE, i "6 9 BUILDING INSPECTOR APPLICATION FC R PERMIT TO ...... ..................... (J�/ ��!1 ... .`. ... .... 1.`. ........................... TYPE OF CONSTRUCTIONS YIOI�(' . v ' .......`.......(.............................�....�....} ...........�?../ !......................19..1....! i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby /appFlies�nfor� a permit according to the following information: /�i� ,��,,-` �J,�� I/ Locationf!....... 1J,1!!!IGC.lN4+ (... a" 1„r6 Id A3;� ,!7„)%kC ��. 1........................................................./Zoo C 0/ �.. ...... J ProposedUse .......................... ............................................. . ........ ......................... ................................ t; Zoning District .................... .. ...........Fire District 'Y Name of Owner ... :... ......................Address ...;.. x Nameof Builder .....,> .............................................Address .................................................................................... 'r Name of Architect ..................................................................Address .................................................................................... s (''j ''- Number 'of Rooms A ............................................Foundation .... ....... a Exterior :S�c 19 Al hl)d ...Roofing .. `!. ! . .�p.... s.�.�a .................. Floors ...:..................................................................Interior ......�.,.......,.... ...........,.................................................. • Heating ' (� ..:....:..�:............. !..............................................................Plumbing .......................... i Fireplace .... ................................................................Approximate Cost ............. ...... .............. ..�. `S..!bd Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ....... ............. Diagram of Lot and Building with Dimensions Fee ` ' ................................... 1 SUBJECT TO APPROVAL OF BOARD OF HEALTH p s � �A, I hereby agree to conform to all the Rules and Regulations, of the Town of Barnstable regarding the above construction. Name ..... ..................................... Kelley, Paul Pool L. 6~62 ' �-. . No —�w445.\ Permit for _l_l/2_mtmry__.. single, family dwelling ' -----~-----`'---^-----'-----' . Cmve Boad '- . ���� �����������'���^������ ` ` Marotooa Mills ' ' . . . ----.----------.------'�---.. ` �aol �^ �elle� Owner -----_______.............................. ' frame ''- of Const_—r__ ^ ----------. Plot � ' Permit Gro ' ' . Date of Inspection , Date Completed PEW/IT REFUSED . , ' / ~ '—'' ............... ---- ................�. —.—.—.--_-------.' ' ..................... —.........—....--.....-. . � ` . � ...--.~.. .----.—.—....--...,.—. 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