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HomeMy WebLinkAbout0205 WEST WIND CIRCLE F �.�,,. - 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 °'"-In Posted Until Final Inspection Has Been Made. Permit 59. Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-1299 Applicant Name: CONDON,JEANNETTE M Approvals Date Issued: 06/08/2020 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 12/08/2020 Foundation: Residential Map/Lot: 121-011-040w _ Zoning District: RC Sheathing: Location: 205 WEST WIND CIRCLE,OSTERVILLE Contractor Name: Framing: 1 Owner on Record: CONDON,JEANNETTE M Contractor license. 1. 2 Address: 205 WEST WIND CIRCLE i - - - - ---_- Est. Project Cost: $25,000.00 Chimney: OSTERVILLE, MA 02655 Permit Fee: $ 177.50 l Insulation: Description: kitchen renovation -new cabinets,flooring,counter tops and f Fee Paid: $ 177.50 appliances I i Date: 6/8/2020 Final: _J Project Review Req: Plumbing/Gas i ((( 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 afte`r,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 inspectio6 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. Work shall not proceed until the Inspector has approved the various stages of construction. Health 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: CANI AIief) Application Number.......lV...aV.... .a..`. .... , .... s aARlverTABM*61 � DING NrKFee...... .2`s�.....T$ 61 �' �.. Zoning Disa.......................... MAY21 0HW Fee Paid...................................................:............ ...... TOWN OF BARNSTAIMV OF BAR '$ 14proval by:........iP. ............on.. .� ....... BUILDING PERMIT > Map...... ......................Pam!... a.�l.....1�.7.�......... ... APPLICATION Section 1 —Owner's Information and Project Location Project Address _ Village JJ . ✓L/l Owners Name > ✓ Owners Legal Address city .s � lIle- state Owners Cell �O �� E-mail Section 2—Use of Structure Use Group [] Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet 0'-�Sgie./Two;Family Dwelling Section 3—Type of Permit ❑ New Construction Q Move l Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System r❑ Addition [j Retaining wall Q Solar .,/ t3Y Renovation ❑ Pool 0 Foundation Only Other—Specify Section 4. Work Description d5-4— w Lag updated:VW2026 i l j t ( .44 1 Application Number.................................................... s A0llcatioeNumb4........................................... , �— -- _—� SedMn3-Detail ------^ See,t66#t�ConitnutionSupervisor 'Cost of Proposed.Consnuction Squme Footaga of Ptojedt Age ofSvwtwe Dig Sato Number. Nerve Telepbono NimiDa i tl Of Bedrooms Fxistlag.— -7btal sY Of 8edtoaitre(proposed) .Addrtrs qty State Zip 110 WH Wind Zone Compliance Method.❑MA Checklist 0 WFCM CoeWlst 0 Design Uc=Nwnbcr_ License Type ExpiragonDete Contractors Email Cell a 1 r Section 6-Protect Sper ifica I wmemuad my«*p"iffitr&iAeerft Mks and r�dmoa,art t��eda�a,elea sep�.l:a tfl.�a:em wm7so CMRtM MupWuitttr Sato&dbly Code.l terdnaaedere0mraoriloai hvpoutao gored+o..pedGciupmldar and I doeuvent Dan mphd by 790 CMIL and ax Town of aamasbin Arndt.capyery-lkeft. ❑wiring ❑011 rank Stomp ❑smoke Detoctors sign Dau ❑PlumUng ❑ Oas O Fire Suppressive Section 10-Home Improvement Contractor ❑HcaOng System ❑ Masonry Chimaty ❑Add)Mooate bedroom - t -- Name—. Telephone Number Water Supply ❑Public ❑Privalo Address_ city Stdie. -Zip t Sewagepisposel ❑Mtmicipw ❑On Site Reg Unction Number--, BxpirWwDote Histork District:' C] Hyannis H'istorle District ❑Old pings Higbway I rmdetsand myrerpaw'EOida under(be mks and maul dow for Nona inpmvwto Caparam s In.rswdsm wldi 76 CMRnrc tdatstcheuTtsSdaBuiWary tbdei linidansrd tMaonsau�oa impeedan prorsduq�klarPealam sad Debris Disposal Facility: lam using a erase❑Yea❑No doomnatianmNtmd by 79D CMA W the Tow of Bamabla Aumb a ropy of yw tt].C-. `Signature Dau �- Section I-Flood Zone Ftood-Tmie Designation _ Section]t-Home OwnersUeense Exemption { -� Within or odjacent.to a wetland,coastal Dank? Yu.❑ No ❑ Home Ownen'Narime: F Telepbone.Number_ Call or Work Number Section 8-Zoning Information t taMentand my mspoatibllklm ender tasrut aand regulations fbrLleersdtamaveticu 3ayovisdr 3n eacrdlam whb7t0' ._.'- CMAar MatneMreta Srus naiWiuy Code.'Itelderslasd the WmbaGbr impaBoo pooeden,tpedGt fntpNam and . Zoning District_ Proposed Use: Lai Aran Sq.Ft, docummwton to Wrad by 780CMR and us Town of Barnstable. 4 Total Fromage. PercemageofiatCoverage NofDwdUg Units(onsite)_ Signature Due s setbacks Front Yard Required Pirol APPirYCAN ATURE Rear Yard Required �p� Side Yard Requited Proposed Signature DOf A�far� �y,/�y�j Has Ws.propmy had relief from the Zoning Hoard in"Nor paW ❑Yes ❑ No Print Notae Ja y)I� yy� e Number p ,,(giy �c>rC�n CZ0 i21 n E-mail orniicto: taut Wdetod:tAtrmdo t.n totnoxo t f • f t I ; t Town of Barnstable SME Building Department Brian Florence CBO " Building Commissioner w &UMTA8LE. MAM• 200 Main Street, Hyannis,MA 02601 '0>Ea 0 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: �► �1 l Q_Q L.�.�1p� 7`1 Please Print � JOB LOCATION: 26 S L.SES'f (,%! I t-i 0 number Pan eet � © l village �vr� "HOMEOWNER": Ia'rN ` C A%', OdJ � name home/pho a ork phone CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for 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 re i menu. Si azure 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 to amend and adopt such a form/certification for use in your community. 1 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): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. on �. I am a sole proprietor or partner- listed on the attached sheet. Remod ship and have no employees These sub-contractors have g, Demolition :29'--, working for me in any capacity. employees and have workers' 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 13. Other employees. [No workers' comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have nployees. If the sub-contractors have employees,they must provide their workers'comp.policy number. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site iformation. tsurance Company Name: I olicy#or Self-ins.Lic.M Expiration Date: ab Site Address: City/State/Zip: ,ttach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ne up to$1,500.06 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of ivestigations of the DIA for insurance coverage verification. do hereby certify i nder the pains and penalties f pe 'ury that the information provided above is true and correct i ature: Date: hone#: 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." 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, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and 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 Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE 'evised 4-24-07 Fax# 617-727-7749 www.mass.gov/dia I 2b4ODH 7 A ro $ � v iu rn � 2 �n A CP U 3 2 206E � 266B 2668 1116D v• r m x r\ o SB66 N7 2668 Ll z -1 V. rn I ko > v � rn o 0 r1 3 = rn LA z m t7 _ r z rJ x i 192 24" 36 47 3" 12" 301' f 2" .3 j I _ iIr I87. 4 - Iif1e� ate a �3-7—a Co. ----Fw ' n; .r 1 7 It r V .r. e it 3 rr 1 ,. 6 W3630� 4 �230 W3Ot 2 1�1/3fi30 DISEi-IQ6L Blr'1i'S1'�` 1GE_GAS.30 SL 6R n k------t-------�-------� ------� ------------ �------------------- ------ - - --- _ -T-' �w O _ — 18616 m F N �, i M 19,2 24rl 47,3 n 12rr 30� " jr 36" >IV 4 t-rr _ - ,! — _. 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Permit Fo,np�" Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. 111 Permit No. B-20-1299 Applicant Name: CONDON,JEANNETTE M Approvals Date Issued: 06/08/2020 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 12/08/2020 Foundation: Residential Map/Lot: 121-011-040 Zoning District: RC Sheathing: Location: 205 WEST WIND CIRCLE,OSTERVILLE Contractor Name: Framing: 1 Owner on Record: CONDON,JEANNETTE M Contractor License: t 2 Address: 205 WEST WIND CIRCLE Est. Project Cost: $25,000.00 Chimney: OSTERVILLE, MA 02655 Permit Fee: $ 177.50 Description: kitchen renovation-new cabinets,flooring,counter tops and Fee Paid: $ 177.50 Insulation: appliances Date: ; 6/8/2020 Final: Project Review Req: ! 1 Plumbing/Gas l 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 reet 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. I 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:i r Service: 1.Foundation or Footing 2.Sheathing Inspection �r �' 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) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: 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. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT C Final: �xE y Application number........ t. ..........�...1.0.� i 1 DateIssued...U�...1.�.1............................................ MASS. M JUN 13 2018 ibg¢ 10� �Sl ABLE Building Inspectors Initials.... 6 .................... Map/Parcel......1.41.0.11.................................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY MORAIATION Address of Project: 2-0 5 1416 4 w (' r 04e r✓' a- ER STREET VILLAGE Owner's Name: -f1"�Crnclo r Phone Number 5 o k 14 4 t Email Address:' Cell Phone Number Project cost$ 3�jT�B(o — Check one Residential ✓ Commercial OWNEt'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CUR Owner Signature: See a �ce.Q Co,�rd�'�-t' Date: TYPE OF WORK ❑ Siding U Windows(no header change)# Insulation/Weatherization ❑ Doors (no header change)# . Conunercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles)Construction Debris will be going to cJa s4,e- nu.-ma �ei�e •�.� - /�e &,r o u CON TRAC'TOWS INFORMATION Contractor's name I/ I g c(t r►'L (' K(- c-1^�/� ✓1 S �Y`/ - P r,.�n n no rG�+ n Home Improvement Contractors Registration(if applicable)# 1�/( 5 B 9 (attach copy) Construction Supervisor's License# /0 (attach copy) Email of Contractor Phone number 800- 3q7_ - Z Z 1 i ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. r . j . APPLICATION NUMBER *For Tents Only* Date Tent,(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature I/V - Date All permit applications are subject to a building official's approval prior to issuance. Page 1 of 10 MA Reg 6146589 CT Reg/0605216 I R Federal ID #20-2625129 Window Contract Customer Inforrhation Jeanette Condon (50.8) 560-7498 () Date:04-08-2018 205 Westwind Cir I<condon@mispin.com Rep:.Richard,McKenna Ostervlle MA 02655 Rep# 40-144:"-65W Location Agreement NEWPRO hereby agrees that it will., for the consideration hereinafter mentioned,furnish all labor and material necessary to install the goods purchased by Owner in accordance with the terms described on the following pages of this agreement (collectively,this "Agreement") at the premises located at: 205 Westwind Cir Ostervi►le MA 02655 Windows Being Installed: 21 Doors Being Installed: 2 Window Details ' Location: Bedroom 1 Window Series: Supermax Double Hung :�— interior Color: White Screen Type: 1/2 Exterior Color: White Grid Pattern/Type:. Na Hardware Finish: White Glass Options: Additional Details:. Additional Labor: Conversion Location: Bedroom 1 Window Series: Supermax Double Hung L_ Interior Color: White Screen Type: 1/2 Exterior Color: White Grid Pattern/Type: ""— Hardware Finish: White Glass Options; Additional Details: Additional Labor: Conversion Location: Master Bedroom Window Series: Supermax Double Hung Interior Color: White Screen Type: 1/2 Exterior Color: White' Grid Pattern/Type: Hardware Finish: White Glass Options: Additional Details: Additional Labor: Conversion `�- Location: Master Bedroom Window Series: Supermax Double Hung Interior Color: White Screen Type: 1/2 Exterior Color: White Grid Pattern/Type: Hardware Finish: White Glass Options: Additional Details: Additional Labor: Conversion M;soacr':ill$%'•:!.'iiialy Jolt Y11.:u k Page 10 of 10 Terms and Conditions Owner has read and agrees to the'terms and conditions of this Agreement. Owner specifically, agrees to the (1) Total Cash Price; (2) work being performed; and (3) work not being performed. Owner understands that this Agreement and any attachments contain all of the promises made by NEWPRO. Owner has been orally advised of his right to cancel this transaction at any time prior to midnight of the third business day after the date of this transaction and Owner was provided with two (2) copies of a cancellation form explaining this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. YOU THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY OF THIS TRANSACTION. SEE THE ACCOMPANYING NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. J riette Condon 04-08-2018 Date Richard McKenna 04-08-2018 Date Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improveme6bConiractor Registration Type: Supplement Card NEW PRO OPERATING,LLC. Registration: 146589 (ration: 05/04/2019 26 CEDAR ST. -"_---='-- a=_ � WOBURN,MA 01801 -_ E" - Y.- _ Update Address and Return Card. SCk 1 0 20M-05117 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Subolement Card before the expiration date. if found return to: Reoistratiibn,. Expiration Office of Consumer Affairs and Business Regulation 14IMk.7 __ 05/04/2019 10 Park Plaza-Suite 5 NEWPROOPERATINGLLG� Boston,MA 02116 VLADIMIR KRUCHYNS--Y`' 26 CEDAR ST. V WOBURN,MA 01801 Undersecretary Not valid without signature Commonwealth of Massachusetts yDivision of Professional Licensure Board of Building Regulations and Standards Const;J4�ri'Supervisor CS-105188 Spires: 11/01/2019 VLADIMIR KRlJCHYNSlYf' 1 PAVILLK)N ROAD •�';,Y AMHERST NH 0$031 Commissioner l Z - - fie CGanz�ncnuaeal�of C�!�aa::acfua:eda Office of Consumer Affahs&Business Regulation HOME RAPROVEMENT CONTRACTOR %=T TYPE:LLC won Nowf _ 03/23/2019' _ ALL W ORK _ VLA4DIWR KRUCI 1 PAVILUON RD. ` ? AMHERST,NH 03031 Unde rsecrerary; I I e The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 '9� www mass.goMfla Workers'Compensation Insurance Affidavit:Builders/Contractors/Electiicians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): �eWpry c7pt?�. �n� LLC Address: o't 62 eeo(gr S-- City/State/Zip: 4/c) Lrel /,16 O1 gh I Phone#: /- ?00 -31/2-L 2 Are you as employer?Check the appropriate box: Type of project(required): I.�arn a employer with S f employees(full and/orpart-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling 'any capacity.[No workers'comp.insurance required.) 3.[—]I am a homeowner doing all work myself[No workers'comp.insurance required)t 9. ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 O Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. ]2.QPlumbing repairs or additions S.a I am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp.insurance.+' 13.[:]Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.lMgOther 01 G 152,§1(4),and we have no employees.(No workers'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 subcontractors 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: (lf7l ;C Policy#or Self-ins.Lic.#:_ k 74 OWL) Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number Ind expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment 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 copy statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verificatio . I do hereby cirtih un er a pa' and penalties of perjury that t ormation provided above is true and correct Signature: Date: Phone#: /- 9 )6- 3 q2. 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#: Aco® CERTIFICATE OF LIABILITY INSURANCE DATE /YYYY) 01/05/2005/2018 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Melissa Pflug Mackintire Insurance Agency Inc fAICN o Et: (508)366-6161 FAX No): (508)366-5202 11 West Main Street E-MAIL melissap@mackintire.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 0 Westborough MA 01581-1931 INSURERA: Sentry Insurance INSURED INSURER B: Guard Insurance Group Newpro Operating LLC INSURER C: Colony Insurance Co 26 Cedar St. INSURER D: INSURER E: Woburn MA 01801 INSURER F: COVERAGES CERTIFICATE NUMBER: 18-19 Master 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 MAYBE 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. ILTRR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD POLICY EFF MAOA/LIDD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR PREMISES Ea occurrence $ 500,000 MED EXP(Any one person) $ 15,000 A A0062403003 12/31/2017 12/31/2018 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY D jEOT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY MBINED SINGLE LIMIT $ 1.000,000 CO Ea'ccldent ANYAUTO BODILY INJURY(Per person) $ A OWNED M SCHEDULED A0092403004 12/31/2017 12/31/2018 BODILYINJURY(Peraccident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY AUTOS ONLY Per acddeM Uninsured motorist BI $ 250,000 X UMBRELALIAB OCCUR EACHOCCURRENCE $ 5,000,000 A EXCESS UAB HCLAIMS-MADE A0092403006 12/31/2017 12/31/2018 AGGREGATE $ 5,000,000 DED I X RETENTION$ 0 $ WORKERS COMPENSATION PER OTH_ AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBEREXCLUDED? NIA NEWC874066 05/01/2018 OS/01/2019 IMandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Limit $1,000,000 Pollution C CSP304242 12/31/2017 12/31/2018 DED $5,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Boxborough Town Hall ACCORDANCE WITH THE POLICY PROVISIONS. 29 Middle Road AUTHORIZED REPRESENTATIVE 119 Boxborough MA 01719 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Assesspr's map and lot number ...y.. 7,. TR E T0�` �y- � 5 Sewage Permit number .......:................................... ..............' Z BAR3STALLE, i House number n' . .S i..... 9 YAe6 Ar- TOWN . OF BARNSTABE SUI�LDING INSPECTOR a _ APPLICATION FOR PERMIT`;TO ...:......................r.... f ,..... ...................:................................................... TYPE OF CONSTRUCTION r .�� ....., 1��` /--� �f �c........:/�.. ...... . ..................f.......................... ....................1••0........ ..........19./E� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the 'f)ollow>ing information: C Location ........, ..cf.. .. :` .....11t1 '' .7...+ //�1��....4. '.�.•!'1. 1.�.�"�..... ..:C.7..(. ................ Proposed Use .............. ...t/I�..� ,//�............................................... Zoning District �.......................................Fire District :;:......... Name oT O''wner .�%. N/..�.. � r�'f ..r. �?� ..�tA�ddTess .......... ................. s Name of Builder . 7.�t��-'V..N ���Ad'dress . � �'��l/ T/ Nameof Architect ..........:.......................................................Address .................................................................................... Number of Rooms .. ..�?...iq....... ..�. R.... .� ✓ Foundation ..... .v. .F.....a •O;'/� ..� 1.�. .! ......... .. Exierior 14/. .�.. 7 R/=.. 00fing ...... H ,f T.......::>..,1,. ............. N .......»... • . .yA.. ...... .....�:. .......... .. ....... .•... Floors ....................r�.�..+:�..., ..1...�"- .. ...........................Interior V L "e Heating "�`.��. �.. .:��:T t`f ....�. ....G. ` -1:.....Pl6mbing . : �...... .. .. ... ...:.............:..:............:. Fireplace ........................:+ ... .. ......................................Approximate. Cost ................ ... Definitive Plan Approved by Planning Board --------------------------------- . Area .......................................... Diagram of Lot and Building with Dimensions Fee. ......`?:................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Y ' OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ...11 ...: Construction Supervisors License ......��. i6n./..RV. DENNIS STAR CONSTRUCTION CO. A=121-11-40 No ..282.15 Permit for .....One Stork ...... ......... ............ Single Family Dwelling ......................................... Location Lot 45, 205 West Wind Circle ................................................................ Osterville ............................................................................... Owner Dennis Star Construction Co. .............................................................. Type of Construction „Frame ............................. ................................................................................ Plot ............................ Lot ................................. Permit Granted .......July 16, 19 85 .................. , Date of Inspection ................ ..................19 Date Completed ...... ..........:...................19 Q �k !'P.,P. i%Z/* As.h4ssor's-rgbp and lot number .. ......... ..... � '�� /�? _ l / �dWsA� �6'cr C�36��',P �s,��d,,�� v� o Sewage Permit number ............ /.......... .... .... .............. p a . House number ��. ................ U �^ �i! �v! '���'� 1� '9�p�NL NAM �p 39• 6 �0 MAIa\ TOWN OF BARNSTA%t' BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..................64-40-4-14-eir, ... .......................... .Q. ..................................... TYPE OF CONSTRUCTION ...........!j/( ,t ...... ...... . lAI.�i................ ....................La...-... ........19.oc7y/ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ ..�r ... ..l►f. ..LY '.7...1!!�I .N.. ....f!'l/.. .�r�r���....�.. .T... <4� Y/.. 1�................. Proposed Use .............. .................................................................................................................. .................................................................................................................. ZoningDistrict C.....................................Fire District ................................................ ........................................................... Name of Owner .u. /V�S..c� T[� ..� 4f.!�,,�7.:: .�s ......... � ../.... .V.." /7.................. Name of Builder ..'.. �..... ./.f (�.. .ti�!� dress ................ V ..v..� 17.................. Nameof Architect ..........Q.........................................................Address .................................................................................... Number of Rooms ..�J.. .a....�..1. .�..�Q.� ..�� .j.7o.Foundation .....P�..V �.Q..7� � 7 ........ Ezierior .......jlll. .I..^T..L..C��y� ...l%ms.Iec-1..Roofing ......AX 1711.194—T.........S.L1. .d, ..... Floors C. . /T I .F.T�...........................Interior .........D.-A.Y. ....... -S Heating JTd..T. .. ...1 .y....C. .....Plumbing ............. .....�r�.f.'X:.Tl7.j................................. Fireplace ........................4.../.`!... .r......................................Approximate. Cost ............. .................... f Definitive Plan Approved by Planning Board ________________________________19_______ . Area j 5. ....�,:-Ar....�. Diagram of Lot and Building with Dimensions Fee I /..�...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH v� t F yg OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable' regarding the above construction. /f Name ..... . . I Construction Supervisor's License ......,�J.�(�1 _DENNIS STAR CONSTR. CO. 1`4 28215 ................ Permit for ..!?R�J�P.0.............. Single...Family.. ......... . ...... . . .. . ...... ............. Location ....Lot...4.5 2.05 .West...Wind...C.irc.le ... .... ........ . ...... Osterville ............................................................................... Owner ....,Dennis Star Construction Co. .................................................... Type of Construction ..........Frame..................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .......ju! Y.. ..................19 85 Date of Inspection ....................................1'9 ,Date Completed ......./--Z-.3.77 .19 r ` *VPf 4j�JY CERTIFY ArMr jmiF�Z07/J NOT LOCAMP /N FEs,. fAL FLOOR MAZA R 4W* � Y ":IS ShowN ON THE F£PERAL. FLOOD.INSURANCE RAM A4P FOR ME rOWN OF CO UNITY PANE4 MO. S,G�toa�sAsEfF�'CT/YE a1T Y NO, R.L.S Aw r4f NOTE. NORTH ARROW NOT'TO 0 6E USED FOR 80UR PURPOSE'S k y h 0 ~Ox Y 3� r� rpi ,Lor 20 14,0 7' 30 t y It, 4,5 00 0 � I a V _ �40 C boa ' *, N o y � � z 4 r e 1 r�ia �Lor ftAN ma anT*4m fmo FOUNPATION OCAT/ON P4.AN •/lY /NSTilI fi�illiENT.�VEY AAIp �V I�R Titi/E- ��_-_ --- — - —---- =_ aw w rAff QANK aV4 Y. IINPIN NO . C/RCG6M.Sr.INCES ARC .OFFSETJ TO BE '= !/�SEA� 6 V fENCE�, N AI•rW, h4E0"d .- . *f*fO)V EW&NEER/NG INC. E.4Sr mL mourH Alit. O.Z536 ale iiE111iM RY, CA'EOEY` 4 aY: PLAN sa PF �'g��•�. TOWN OF BARNSTABLE BUILDING DEPARTMENT .ease. TOWN OFFICE BUILDING �°8 i6�9• �� HYANNIS_ , MASS.'02601 i 9, MEMO TO: Town Clerk 1V FROM: Building Department DATE: !a An. Occupancy ,Permit ,has been issued.for the building authorized by Building Permit $�..__...._.__.�...._........_.._..j4'�...._...........:................. ...................._...........__....�.............._..._..........:......�....�.....�... issued to .....` ' _ .......... �' ... !...._.. ------:._. Please release the performance bond. ��[,�.,,, Y,��T�,.,��t'; alcs7: :tb�c: :: ►^* :�i-, ar .. a; :.3:4;ia. r „� 3+:: y�► �t,�. -,v e.+,�Z.,y:�,k�►'"§ 7 o• ° TOWN OF BARNSTABLE 'ePermit No. --____--.28215_ BnilYdtng Inspector Una s tr; _ Cash �/ -----__—_-- • +1esw OCCUPANCY PERMIT Bona _____X _-- ....�1 - - v , � Issued to Dennis Star Construction Cnddress lot ##45 205 West Wind Circle, Osterville Wiring Inspector �j� Inspection date Plumbing Inspector/ / \ 1\ Inspection date Gas Inspector Inspection date Angineering Department\ j � �� � Inspection date/' _ S� Board of Health � �� Inspection date �y THIS PERMIT WILL NOT BE VALID;AND HE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED,=BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ......... //f�...:... 19.21 .......... e `..... .... .. ...».»»»»»- -- Building Inspector