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0078 WEST BAY ROAD
may. - ----�- -- n "` - �" - Oda �\ \\ x c k � , r• ,: �; ��. +. Town of Barnstable �Ap Q- , � 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 Posted Until Final Inspection Has Been Made. ` Permit Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-232 Applicant Name: Rodney Tavano Approvals Date Issued: 01/27/2020 Current Use: Structure Permit Type: Building-Sheet Metal-Residential Expiration Date: 07/27/2020 Foundation: Location: 78 WEST BAY ROAD,OSTERVILLE Map/Lot: 117-120 Zoning District: RC Sheathing: Owner on Record: HOFFMAN,GLENN& LAURA L Contractor Name: RODNEY N TAVANO Framing: 1 Address: 4 ABBOTT LANE#6 Contractor License: 3449 2 CONCORD, MA 01742 Est. Project Cost: $20,000.00 Chimney: Description: The installation of 2 hydro-air heating and cooling system . Permit Fee: $85.00 Insulation: Project Review Req: Fee Paid: $85.00 ` Date: 1/27/2020 Final: Plumbing/Gas Rough Plumbing: ,Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced withiri-six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough 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 Final Gas: 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. Minimum of Five Call Inspections Required for All Construction Work: f,.' Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 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 Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health 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). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: p�0%A _ - Town of Barnstable Building •�., ewR�srweu� Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept _ I a� A`0 Posted Until Final Inspection Has Been Made. S m Perit , Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. �lj ►� Permit No. B-19-4075 Applicant Name: CAPE COD ALARM CAPE COD ALARM. Approvals Date issued: 12/06/2019 Current Use: Structure Permit Type: Building-Smoke Detector-Fire Alarm Dection Expiration Date: 06/06/2020 Foundation: System Map/Lot: 117-120 Zoning District: RC Sheathing: Location: 78 WEST BAY ROAD,OSTERVILLE Contractor Name: GENE A CORMIER Framing: 1 Owner on Record: HOFFMAN, LAURA L TR Contractor License: 1592 2 Address: 4 ABBOTT LANE#6 Est. Project Cost: $2,900.00 Chimney: CONCORD, MA 01742 Permit Fee: $35.00 Description: INSTALL SMOKE, HEAT AND CARBON MONOXIDE DETECTORS. Insulation: Fee Paid: 535.00 CO and SMOKE DETECTOR REQUIRED IN BASEMENT. Date: 12/6/2019 Final: Project Review Req: wt�G`�� Plumbing/Gas 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. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough 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 Final Gas: 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. Minimum of Five Call Inspections Required for All Construction Work: f Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 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 Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy . Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Pe sons con ting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: C� BEDROOM 'RE�� � �V a LIVING �� i►����a� �� KITCHEN oT�, iu�ir,T�'�'` P� • Hi a �.. , ROOM (s �'� -..���. 3(s N E. DowN T DINING ROOM TUP vs FIRST FLOOR BASEMENT LEGEND: BEDROOM lo" BATH BEDROOM s ogiaDE`ocro4 78 WEST BAY ROAD, OSTERVILLE IN my CAPE COD ALARM : I 4 6: 1 / s <�wN BEDROOM - .. 204 Old Townhouse Road CJ West Yarmouth,MA 02673 SECOND FLOOR CAPE COD ALARMC A Tel: (800)468-8300 Bill Fallon (568)398-6316 Systems Design l nginecc Sales Manager Fax:(508)398-5666 biil@capecodalarm.com www.capeco&darm.com z -- "a .� 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 RAMSTA "AS& Posted Until Final Inspection Has Been Made. Permit .esp.e�� �t Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-2904 Applicant Name: PAULJ MAZZOLA Approvals Date Issued: 09/30/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: - 03/30/2020 Foundation: Location: 78 WEST BAY ROAD,OSTERVILLE Map/Lot: 117-120 � Zoning District: RC Sheathing: Owner on Record: HOFFMAN, LAURA L TR Contractor Name: PPAUL J MAZZOLA Framing: 1 Address: 4 ABBOTT LANE#6 Contractor License: CSF�A-057934 2 CONCORD, MA 01742 Est. Project Cost: $ 175,000.00 Chimney: Description: REPLACE EXISTING DOOR'S,WINDOWS(REPLACEMENT UNITS SAME Permit Fee: $942.50 OPENINGS) EXTERIOR ROT, ROOF SIDEWALL REPAIR, (INTERIOR)- Insulation: KITCHEN, BATH REMODLE, HVAC CHANGE OVER UPGRADE. Fee Paid: $942.50 Date: 9/30/2019 Final: Project Review Req: Plumbing/Gas ``• %ram 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. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and st uctures 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 Final Gas: 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. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 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 Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health 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). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 1 a Applicatio V Health Division Date Issue 9 �. Conservation Division Applica 'on Fee Planning Dept. Permit e Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Q WPST ?*)( 1�04 Village 0�' oe0//�� /�.4- Owner N_Lv/�-� /1!1 Address SAI"1 S �oy< Telephone 7174 Permit Request Re Act E 1 Tip► 75 Ex-k.4_)o2 Ru'f ouF Slug II 4i4 �' T'�io2 - r►wDre V4[, C a 0V(1L Square feet: 1st floo propotd 2r�rLfltr�r' ��- propose Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1 000-°Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ;7Two Family ❑ Multi-Family (# units) Age of Existing Structure Io?D Y Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes U/No Basement Type: Full E(Crawl ❑Walkout ❑ Other NRIF ftA /E4AtF CRAW L, Basement Finished Area (sq.ft.) n Basement Unfinished Area (sq.ft) SOO Number of Baths: Full: existing v1 new Half: existing - 0 ' new Number of Bedrooms: 3 existing 0 new Total Room Count (not including baths): existing �_new First Floor Room Count 4 Heat Type anZes M Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑ N / " o o Fireplaces: Existing New Existing wood/coal stove: ❑Yes e'No Detached garage:;exist e ' ting ❑ new size_Pool: ❑ existing ❑ new size Barn: ❑ existing ❑ new sizeAttached garage: ing ❑ new size _Shed: ❑ existing ❑ new size — Other: BD�I PING DEPT. Zoning Board of Appeals Authorization ❑ Appeal # Recorde Commercial ❑Yes ❑ No If yes, site plan review # SEP 0 5'2019 Current Use Proposed UseTOWN OF STABLE APPLICANT INFORMATION (BUILDER OR HOMEOWNER) N.JLS Cell 57p_717L -a4 19 Wdttc�uo�T C�Raup Lc.0 D-VA Name Rut, d�11J1�1�-alp}- Gc1 3.1d,0 'S IPC Telephone Number SDI -498 -9894 Address 119 RT IA9 License # 05FA • 0!9767 4 �14RSMAJ M I I/S 104 OR64e Home Improvement Contractor# l5'�a53 Email c.i �c:�� S Worker's Compensation #, _11o?a00?6;U?x0 I ALL CONSTRUCTIO EBRIS RESULTIN OM THIS PROJECT WILL BE TAKEN TO tog Oin SIGNATURE DATE 9 FOR OFFICIAL USE ONLY - ' APPLICATION# DATE ISSUED ` MAP/PARCEL NO. ADDRESS VILLAGE. OWNER DATE OF INSPECTION: G FOUNDATION a FRAME INSULATION - FIREPLACE ELECTRICAL: ROUGH ' FINAL PLUMBING: ROUGH FINAL GAS: ROUGH r FINAL FINAL BUILDING y DATE CLOSED OUT ` 'r ASSOCIATION PLAN NO. 4. r Town of Barnstable Building Department Services RARNMBU& ; Brian Florence,CBO Building Commissioner a 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder i as Owner of the subject property hereb authorize ` �to ton my behalf, Y in all matters relative to work authorized by this building permit application for: WIC, 1 0 ns�crv'i 1 1� (Address o Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. G� Si a e of Owner U0Signature of Applicant Lku,1' �6U(rAav\. Print Name Print Name 3 ZI Date QYORMS:OWNERPERM1SSIONPOOLS Rev:08/16/17 ]he Commonwealth oj•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 Legibly Name(Business/Organization/Individual): WA-qv v at r Q20W LLC MA_ 6 CZ S ;dkegS I M C Address: 11 ci A&49SJC#_� Ay1 LJS 04VQ /A42" - City/State/Zip: AAA Phone#: Sy8 —4,18- q6 34 5M t3 -7X-A4'75 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with -A— 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. Remodeling ship and have no employees These sub-contractors have g. Demolition workingfor me in an capacity. employees and have workers' y p ty• 9. Building addition [No workers'comp.insurance comp.insurance. required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12. Roof repairs insurance required.]t c. 152,§1(4),and we have no 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. t 1 Insurance Company Name: 6akAA �?.pTcCtt�l.� �Su2At z^P Policy#or Self-ins.Lic.#: 4=66 70 A. S61 Expiration Dater Job Site Address:q a Wee&W RDA City/State/Zip: Attach a copy of the workers'compens declaration page(showing the policy number and expiration date). Failure to secure coverage as requ' under Section 2 A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 an�or o -year imprisonment, well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day r st the violator. Bea tsed that a copy of this statement may be forwarded to the Office of Investigations of ther stuance cove a verification. I do hereby certi under a pains an enalties of per' at the information provided above is true and correct Signature: Date: Phone#: Official 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#: Client#: 766388 2WA000ITGR1 /rIPORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/03/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: The Hilb Group of N.E.dba PHONE 508 775-1620 FAX 5087781218 A/c No Ext: A/C No Dowling 8r O'Neil Insurance Agy E-MAIL ADDRESS: P.O. Box 1990 INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER AArbella Protection Insurance Co 41360 INSURED INSURER B: Waquoit Group LLC DBA GCI INSURER C A/0 Paul Mazzola; P.O. Box 509 INSURER D Marstons Mills, MA 02648 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY 8500069262 11/19/2018 `1111912019 EACH OCCURRENCE $1 000 000 CLAIMS-MADE �OCCUR PREMISES EaE�r nce $100 000 MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY X JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Pera ccdent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ A WORKERS COMPENSATION 422007823501 11/19/2018 11/19/201 X SER OTH- AND EMPLOYERS'LIABILRYTuTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N E.L.EACH ACCIDENT $500 OOO OFFICER/MEMBER EXCLUDED? � N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500 OOO DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Glenn and Laura Hoffman SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 78 West Bay Road ACCORDANCE WITH THE POLICY PROVISIONS. Osterville, MA 02655 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S242191/M242190 NS2 DESCRIPTIONS (Continued from Page 1) Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. SAGITTA 25.3(2016/03) 2 of 2 #S242191/M242190 i Commonwealth of Massachusetts Division of Professional Licensure Board of Buildirig Regulations and Standards Construction.S46WisorO &2 Family CSFA-057934 E-jcpires_06/19/2021 PAUL J MAZZOLA m PO BOX 509 MARSTONS MILLS MA'i02648 - � Commissioner , .� �orrirrea2urw.�l�a��i�adf�c�ell� Office of Consumer Affairs&Business Regulation q HOME IMPROVEMENT CONTRACTOR TYPE:+Coiporation N agIMLaticia Expiration is t52259ffi 10/14/2020 WAQUOIT GR.;'!F &C f D/B/A G.C.I.B r'LDERS;� F G PAUL J.1A42Z0L`i4 f/ 644 RIVER ROAD" =a 6 _ MARSTONS MILLS,MA 02648 Undersecretary�I • Construction Supervisor 1&2 Family Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call 1617)7273200 or visit www.rnass.gov/dpi Registration valid for-individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston,MA 02118 Not valid•without signature. . W) 3- D- 17 Town of Barnstable `RECEIPTS 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: B-17-549 Date Recieved: 3/1/2017 Job Location: 78 WEST BAY ROAD,OSTERVILLE Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: JAMES P CURLEY State Lic. No: CSSL-099138 Address: Centerville, MA 02632 Applicant Phone: (508)790-4508 (Home)Owner's Name: BAKER,BRUCE R& LINDA H TRS Phone: (508)428-5479 (Home)Owner's Address: 78 WEST BAY ROAD, OSTERVILLE,MA 02655 Work Description: Strip and re-roof approximately 5 square of asphalt shingles. Total Value Of Work To Be Performed: $3,000.00 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: James Curley 3/1/2017 (508)790-4508 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $3,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $35.00 3/1/2017 $35.00 ?OOOC-X30IX-?D{}0{- Credit Card 5483 _.Total Permit Fee Paid: $35.00 ....................................................................................................................................................................................................................................................... I `:gin-` '� YTHIS IS NOT A PiE-RMIT '� r oa ,e Tp� Town of Barnstable *Permit# 3 Expires 6 months from issue date egulator ServiEees - nUss. g _ -• .•Geiler,Director 6`°� J T• ._.�_.....-.._..BuUdingD"!on- APp, 1 . _. - '— -"Torn Perry, Building Commissioner �0 . ...200 Main.9treet,• Hyannis,MA 02601-•• TOWN Oa= t�,q tit��sT�,� Office: 508-862-4038 Fax:•508-790-6230. . .. ;� . -�.__; : .. . RESIDENTIAL ONLY. -• - XPRSER1VffY'� I��IA�'LON - / Not Valid without RedX--Press Imprint Map/parcel Number I t property Address I �� Minimum fee of$25.00 for work under$6000.00 Residential Value of Work � � ��-- f . Owner's Name&Address Telephone Number Contractor's Name Home Improvement Contractor License#(if applicable) S 6 Construction Supervisor's License#(if applicable) g�Worlmnan's Compensation Insurance. Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ Ihave Worker's Compensation7asurance Insurance Company Name �- Workman's Comp.Policy# 1 f Copy of insurance Compliance Certificate must be on file. Permit Request(check box) o Re-roof(stripping old shingles) All constriction debris will be taken to e ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re--side Replacement Windows. U-Value___(maxinxum•44) *Where required: Issuance of this permit does not exempt compliance with other town depa trnmt regulations,i.e.Mtoric,Conservation;etc. *** Owner must si o er Owner Letter of Permission. Note:. Property �•� P t3' ome t a rs License is required. Signature Q:Forms:expmtrg Revise063004 0 lip Fraser Construction Roofing Siding Specialists Payable immediately upon completion NO MONEY DOWN - NO Payment at the start or part way thru Payments accepted are: CASH - CHECK- MASTERCARD - VISA.-AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 1 %s%for every 30 days the payment is late.. Possible Extra-After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation be not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$4.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or.other carpentry needing replacement will be done and charged for as an extra at the rate of$45.00 per hour, plus materials, plus 20% overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for.10 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the first 5 years, and then on a pro rated basis for 30 years total if the shingles become defective. CERTAINTEED Warranties the shingles to be ALGAE resistant for a full 10 years. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this . proposal. FRASER.CONSTRUCTION: Carnes.Workman's Compensation and Public Liability Insurance on the above work. DATE OF ACCEPTANCE: �0 0 00 SUBMITTED BY: Z? Homeowner nstruction Fi r r, ..AN z2 k i r Town of Barnstable . �.� Regulatory Services T)lomw F.Geiler,Director WAM '°�En MAi Building Division TomPerrh Building Commissioner 200 Main Street, $Yannis,MA 02601. R,wV own.barnstable;ma.us Fax: 508-790-6230 Office. 508-862-4038 Property Owner Must Complete and Sign This Section if Using ABuilder as Owner of the subject property .to-act on mybehalf, :hereby authorize in U fitters relative to work authorized bythiss building permit application for; (Address of Job) Date Signature of Owner Print I'Zame • i "UR___ The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestlgadons _ 600 Washington Street, a Floor ---- Boston.-Mass. 02111 Workers' Compensation Insurance Affidavit:Building/Plumbing/Electrical Contractors e `h name• fN� address: 7 I`", city U state: zip: phone# work site location(full address)' ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction[]Remodel ❑ I am a sole proprietor and have no one Working in any capacity; ❑Building Addition I am an em)loyer providing workers compensation for my employees working on this job. .. ,..,s �.•>" +.�.`.'Y �.:r.......{ ...+._ ..�..n nC.. .,...r .. P• , r ';.. a �r..i s>ti�.' . Z. Ly 'g,:'r ,iq+: F'� s * - rlaFr���'4, a+���� .�A3''S rhx. �r��. ,��'�d( '�' y �`t-'i�. ,�.� y 7 f�. r ..r � .9., �.`•�:Y:i r.. :-.,`�,._: l:r'� Wit ? .l 'o.y ✓+"YA., +� H''1`?''.'• � f.::�7r°'� }..-.:ir• <�.Li''-}.in.f r!+,�;. r..i•.:',>'y+J•.R,.,rJ.<'>;: n..?y44 t i� _.:,�-:.•:,K<o'{ [ 8(Id�CSS' i ���it�•�aW��•5> "'N e7 x•+" rr.,.x 1 L. �'> X � u e kN :;-v a l �, t h �i:lJ;� f g' S•ts�i'' us wa Y Q,,, A + e r$ rt 3`s "t"• y �� - •>,.,c Y T t?: r 4- vy >ii'y .Lr. a r2 F .+>, �'�"tz ••�. 7;r :�¢ 'r}.3 t Lht+��5-y ''i,�. '+rt �Cr {c i o =ri '' a^C^�• ter'i`n•��x� ..t�' 'd` a [`p"'7l.!'F4"4.�fi�'T'Jti'h t'.�' �'$a2�.3�5 4_.. t�tlbHU.iF m Y✓ f. 4 - . 1f !�'`-a J,Lr {'.tr• c!� fi R 9 3`. '{•s 54 J' i4 I Str ,P \ � �'�"(4r'e..:�:�.��:...:4:':y+: � .S� i �_^': y'�<+f:4,!•'1' �+.6 �•4 8 t.' � ¢ �� ,4t7. k� f„A G , - • J�-e msitrance:ca._.... f.,:.J:L:' _. ; _...-' 'z�„��..Y•�..�._.�.�:...,_,.<.P. o rc r .;>.; ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have compensation polices: the following workers' _ P P :.ar., „v,. J.T,b-?1'B' ,'fir..h .eb ..:�,:!� .•} .t{:. .t -..._.:.,:.r.-.:,. .. .k_:...,r.... ::: r.,...,, kdx:'c>:.,..✓, S^ ..,y.;. .-r.F�"": �:`>*z r S4 f; ca pa v a Y%- q< 5iii y 1y r L .. .. .. .r ,,.,..A.-. r.ray•;. �-a ::�.,N it. . ... .. .. ... ....�,.,. .. ... .._...:... .+>.. . .. :'.. :`_sus: 1�oiie� , k r o S xr. -bit eza —7-7777 d,r r. i r. �a•ddFeSS..'.":L'S. .>t�;f... .Y,: ."V. h,_ ..1+[ b'Y.:.'K�.1:. .L �.4, _1. i :d;:� - yr.. .., .�.. ..:... ..,' UR,:....(.....,,>_::::.: a.[>•�.. '-'1.'_A'.. :c�rt�•. phone#i r'~' r : .• c �' xyy,, r a:",� r r qf� y � �fy r y t: i r ttl'SuranliC[:COu ..:....>..:.. ..:,.. *..... : �. _... ...:: ohc. .#. - .ee Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine 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$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify er the p and ties jury that the information provided above is true and correct Signature Date -�/s/S^ Print name ✓ {��`h� 1—✓lGc ��� Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#;' ❑Other (revised SepL 2003) I I 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 required. 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 situation. Please supply company name, 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 permitilicense number which will be used as a reference number. The affidavits may be returned to 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. 916A MEN The Department's address,telephone and fax number:- ` The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406 I 1 ` &5 !7 "Engineering Dept. (3rd floor) Map 1 1 Parcel 1 " '22�D Permit# 72— House# Date Issu d 2 — 9y oaX (3rd floor)(8:15 -9:30/1:00-4:30) Fee Confice (4th floor)(8:30- 9:30/ 1:00-2:00) Pla1st floor/School Admin. Bldg.)DeApproved by Planning Board 19 ��: i BARNSTABLE. j rFD 39. TOWN OEBARNSTABLE Building Permit Application ' Project Street Address 79 /,/jam Village 1 Owner f�tlLC F ,� /ram- Address (�/E is C/LI//�/ Telephone Ya P_ - 6_�P_915� -Permit Request /1.P - 1-0 07' -First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ fV0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) i Age of Existing Structure /9'G o,s 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 No.of Bedrooms: Existing INew 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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. 'ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT ILL BE TAKEN TO r /P AIIl SIGNATURE DATE ZZZ/ BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) a % FOR OFFICIAL USE ONLY n PERMIT NO. ' DATE ISSUED ' MAP/PARCEL NO. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: - � l FOUNDATION FRAME ` INSULATION FIREPLACE , ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: - ROUGH .} FINAL FINAL BUILDING n r DATE CLOSED OUT ASSOCIATION PLAN NO. he Town ®f Barnstable 2 $� Department of Health Safety and Environmental Services Building Division 367 Main Strctt,Hyannis MA 02601 Rziph Office: 508-7,90-6Z7 Building C : Fax: 508-7,90-6Z 0 For office use only Permit no. Date / 19- AFFIDAVIT HOME MIPROVEI ENT CONTRACTOR LAW SUPPLEMEiYT TO PERMIT APPLICATION ` ires that the "reconstruction, alterations, renovation, repair, moderni=ticn. MCL � 142A requ conversion, improvement, removal, demolition, or construction of an addition to any pre-existing to owner occupied building containing at feast one but not more than fou tee dwelling units s,°wiih structurrs which are adjacent to such residence or building be done by regis certain exceptions.along with other requirements. Type of Work:- ►-gyp # z_ -� Est. Cost Q Address of Work: Owner's Name Date of Permit Applic=tion: L;'iA9 I hereby certify that: Reglstrrtion is not required for the following resson(s): Work excluded by law _Job under 51,000. Building not owner-occupied Owner puffing own permit Notice is hereby given that: OWNERS PULLING TfIE� OWN PERMIT OR DEALING WITH UNREGZ� CONTRACTORS FOR APPLI N PRO OR GUARANTY FUND UNDER MGL HOME MOROvEMENT WORK DO a � I42A i ACCESS TO THE ARBITRATION PR SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Cilntractor Name $egistratioa lYo. Date TI1C' I/111111U% PClIIlTI U . lissacll uscru DeptirJlllt_'111 of Ind11Srrial Acc1dews .. . �. ;; Office Of h7YeslfgallonS V �_ {__.; �• WH !f uslting wit Slrcct Btisu ll. 3fasr. 02111 Workers' Compensation Insurance Afriidavit Applicintinfnrniatinn " Ml TSFe f RINT'lebiiiiv ttat'ic e� nc^•inn• City �f ,�'-/C�!/, x �� t� a t7 s~ nhonS: I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity �. I am an empioyer providin_�workers compensation for m\ empiovees working on this job. cmmwtrn• nnm(•- 'ttltlrrcc- cite• nhnnc 0- incnr^nrr rn nnlicv d i am a sole proDrle-or. -eneral contractor, or homeowner(circle ane� and have hired the contractors listed beiow �A the "ollowin^_ workers* compensation police:: cmmrl•lm' nntnr- n(I rl rr<•• cir— nhnnc a• in<ur^nrr rn nniic� cnninnn rr,r. ntidrr<<• rir� nhnnc inenrnrc rn nniic� Altzch additional sheet if necessary ._.., _�:'•,:•.Y .••.... ,.�-z- _-....—.__._. . Fnijurc to sccurc cm•crace as required unucr=uon—'A of I%IGL 152 can lead to the imposition of enmtnai penalties of a line up to 51�OU.UU anurur unc .cirs imprt>onment:t. %%cil as cil-ii penalties in the form of a STOP~FORT:ORDER and a fine ufS100.00 a day against me. I understand th=.t copy of this staicnicut mn-, be furwnrded to the Office of Im•estications of the DIA for coverage verification. 1(io hercnr crr7ifr urttier the pains and petraities o crjurt•that the information provided above is true and correct. Si=^�tur� Date lT Pr nt .s s ,��2yG •�� Q� Phone; atTicini use univ do nut write in this area to be completed by city or town ofliciai E permit/license tt rtt3uildin_Department city or sn��'n: ❑UCcnsing Board L x t. " chcci: if imrncdiatc respunsc is required ❑scicctmen' Orr- C" [ittcaith Department contact ncrsnn• phone#• rrUtttcr ` Information and Insrructio;ts - Wssac.'lu.sctts General Lzws chapter 152 section 25 requires all employers to Pmvide workers' coin Pcns:!:itln employees. As quoted from the "ta��'".an craplurer is defined as every person in the service at another untie? -,.- - col::r-= of hirc_ express or implied. oral or written. �.. An rmplarer is defined as an individual. partnership. association. corporation or other legal cntitv.. or any ttre, cr the roreuoinu en__z_.•d in a joint enterprise. and including: the lei l representatives of deceased em c piover_ or:;: rec_^:ver or tntstee of an individual - partnership. association-or other legal entity. employing employees. Ho«e•. m"•ncr of a d%vellin_ housc !laving not more than three apartments and who resides therein. or the occupant of:l:e dN%clling, house of another�yho employs Persolls to do maintenance;construction or repair work on such dwc`N; : or an glee __rounds or building appurtenant thereto shall not because of such employment be deemed to be an e.^-p:. V CIL dianic.- ! sc:::ion _5 ulso states that every state or local licensing ngency shaII withhold the issu:nce o. W:11 of a license or hermit to operate a business or to construct building in the Commuillv enith for::n` c::tlt Who igas not produced acceptable evidence of compliance with the insurance eoverabe required. Ae�..ion;.tly. neither the commomvealth nor any of its politiczl subdivisions shall enter into any contract for:he per:urniz::ce of public work until acceptable evidence of compliance with the insurance requirements oft his c:.:=: hce:: orc::::::tcc to the contrz=inc authority. �l�lliicants P!.ase :lid in ;he %vorkers' cotnpensation affidavit completely, by checking the box that applies to ;your situa:i;�:l c: suppivin,_, cornpzny :lalnes. zddress and phone numbers as all affidavits may be submitted to the Deparnicrt of 'nc a:riai �cc:de:as rat c011tlrmztion of insurance coN err_e. Also be sure to si;a and date the a�dati'tL lire :�•. it shouid be re:urlle, :o the cin• or town that the applicztion for the permit or license is being re_qu-ate-- r ::ic Jeca;t:lte::t Ot'it1dL'siriai accidents. SItould you have am, questions re=rdinc the "law-or if you are 'eqc .o oc:z:n � %vcrkc-s' cclllpc:: fell polic}. please coil the Depatment as the number listed bc!ow. Cite .)r Towns P!:-r= e �urc :lea: :ile .:ffida\•it is complete and printed !egibly. The Department has provided a space at tlte 'o0-- the •- aa�it for you to fiil out in the event the Office of Investigations has to contact you regardin` die applic:n:. Fo be _ : :o fiil in the permit/license number which will be used as a reference number. The affidavits may be re:u: ,:le 0:n;.mnent by mail or FAX unless other arrangements have been made. The �ft;;e of Investi_ations «ould like :o thank �•ou in advance for-,•ou cooperation and should you have any ques: pie"=! do not hesitate :o _lye -is a =11- i,te Depar-:aenr s address. teieCilone and fax number. TIte Commonwealth Of Massachusetts Department of Industrial Accidents - Office M Investigations --- 600 «Vashingion Street Boston. Ma. 02111 fax 1: (61;� --749 �itunc =. . 611 _: - '900 c�:r. 406. 409 or • TOWN OF BARNSTABLE • . BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE y JOB LOCATION 7F Number Street address Section of town "HOMEOWNER" � C/� yak So? Name Home phone Work phone . PRESENT MAILING ADDRESS , 63� City town State Zip cod The current exemption for "homeowners" was extended to include owner-occ= dwellings of six units or less and to allow such homeowners to engage an is dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Perscn (s)' who owns a parcel of land on which he/she resides or intends to side, on which there is, or is intended to be, a one or two family dwelli::c attached or detached structures accessory to such use and/or farm struct,=* A person who constructs more than one home in a two-year period shall not r ' considered a homeowner. Such "homeowner" shall submit to the Building Off-: on a form acceptable to the Building Official, that he/she shall be resmans for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the uilding Code and other applicable codes, by-laws , rules and regulations. he undersigned "homeowner" certifies that he/she understands the Town of arnstable Building Department minimum inspection procedures and requiremen- nd that he/she will comply with said procedures and requirements. OMEOWNER`S SIGNATURE %���� A_-- APPROVAL OF BUILDING OFFICIAL cte: Three family dwellings 35., 000 cubic feet, or larger, will be requires o comply with State Building Code Section 127. 01 Construction Control. HOME OWNER'S EXEMPTION r_ The code state that: "Any Home Owner performing work for which ,& buildi:c permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of 'Construction Supervisors) ; provided that is Home Owner engages a persons) for hire to do such work, that such Home Oc.;. shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see .Appendix Q, Rules and Regulatic:;s for . licensing-''Construction Supervisors;" Section 2. 15) . This lack of iwaren often rosults in serious problems, particularly when the Home Owner hires unlicensed, persons. In this case our Board cannot proceed against the unlicensed person as .it. would with licensed.. Supervisor. . _The Home "Owner ac 3s supervisor is ultimately responsible. 'o efisure that the Home Owner is fully aware of his/her responsibilities, m: =unities require, as part of the pe?znit' application, that the Home Owner :ertify that he/she understands the responsibilities of a supervisor.-, On t .ast page .of this issue is a form currently used by. several,,towns:,. You may are to ame^d `and adopt such a form/certification for use in-your ccmmunit.- . • i { scp NEW SWAM, 0100 I ` CA11 ��5 C �3 c� 4D ' ZXIST? NON &Ae� �SLANy� WALL � �sl�' NEW L -roe wa..� s, j4e10 r a a -n o /b o Reif l �d Barnstable Bldg.Delat, Approved by: ____ - -- �, ..�.�.. Permit#: 'Nil s SCALE: APPROVED BY: DRAWN BY DATE: 9 ' .2�l REVISED JCA- DRAWING NUMBER