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HomeMy WebLinkAbout2355 IYANNOUGH RD/RTE 132 (2) ©J, 40 - t F P f'1 t ®0 Q 8 W • Y o •�p 1 rS � .� Town of Barnstable Building Post This Card'.S6 That it is Visible From the Street-Approved Plans Must be Retained'on'Job and this Card Must be Kept' vM" Posted Until Final Inspection Has Been Made. Permit y Faux+° Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-3604 Applicant Name: JAMES F MCMORROW Approvals Date Issued: 11/01/2019 Current Use: Structure Permit Type: Building-Deck Expiration Date: 05/01/2020 Foundation: Location: 2355 IYANNOUGH ROAD/RTE132,WEST Map/Lot: 216-044 Zoning District: RF Sheathing: Owner on Record: PLIKAITIS,ROBERT&WILLIAM Contractor Name: JAMES F MCMORROW Framing: 1 Address: PO BOX 280 Contractor License: CS-098120 2 WEST BARNSTABLE, MA 02668 �T Est. Project Cost: $ 1,500.00 Chimney: i Description: add 4x10 section of deck Permit Fee: $ 110.00 •I Insulation: y 1 Project Review Req: Fee Paid: $ 110.00 Final: Date: 11/1/2019 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: 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 Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT r The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass govIt a Workers' Conipensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbeis Applicant Information Please Print Leeibly Name(Business/OrgmilatioTAndividual): 711a )AA. Address: VT City/State/Zip: Phone M Are you an employer?Cheeli the appropriate boa: Type of project(required): l.914am a employer with—_ 4. I am a general contractor and I 6. New construction ❑ employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- wed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition working for mein any capacity.acitY• 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 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 contractor;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. , lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: r Policy#or Self-ins.Lie.#:� 00 .S Expiration Date: Job Site Address: 3 City/State/Zip: tu,� J� T 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb c under the pains and penalties of perjury that the information provided abov is a annd�corriect Signatxue: Date: -�2— Z% -73 Phone#• QJ)7ckd 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 id 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 gmrmds 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 constrict 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-contractors)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 retuned 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 lime. City or Town Off cials 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 permittlicense 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 burn 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 O fflee of Investigations 600 Washington Street Boston;MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www:maw.gov/dia ,nub `P�,hs+abk \ 4 y 13 a Ito p° !�Ia Y � _ r� 'r Town of Barnstable,Planning 8c Development Department 1 JSE 101d King's Highway Historic District Comm, e200 Main Street,Hyannis,Massachusetts 02601 OCTPhone-.508.862.4787 Email erin.loeAn a.ownbarnstslile.u�r.usCERTIFICATE OF EXEMP�YON P��°�NING u Application is hereby mad%with four(4)complete sets,for the issuance of a Cats tcate of Exemption under Section 6 and 7 of Chapter 47 0,.Avis and Resolvts of MpSsachusetts,1973,as amended,for pmposcd work as described below and on plans,drawings,or photographs accompanying this application: —144 Date I Q2/17 Address of Propmed work, Assessor's Map and lot# House=#R�JT .Street �l �f��J� � lC��' Village: r V, This pplication is for an exemption of the proposed construction on the grottlids that work: Will not be visible from any way or public place Q Is within a category declared exempt by the Old Kings Highway Regional Historic District Commission ❑ Other cr gtiou ,f Pro osedd b* ' U , Agent or contractor(pleose p . t): 1 �, /}� Ly In tr►�' n/ Tel.no. �l d Ct Address ( ,l r `� 1 Owner(please-.print): 1 . 1 r 1 I Tel no. Owners trailing address: Signed,Owner/C.ontmetor/Agent Checklist Four complete sets of the application and supporting documentation 0 $ Filing Fee(see attached schedule) For.Committee Use Only This Certificate is Hereby APPROVEDID Date: APPROVEDCommittee Members Sigaatures: OCT 3 0 2019 Town of Barnstable Old King's Highway Conditions of approval: Committee 0%XExeerttonFoM 3017 �C HOUSE t HOUSE y 3 ADD 4' TO DECK APPROVED [REBUILD DECK IN-KIND AND ADD 4' OCT 3 0"2o19 Town of Barnstable Old King's Highway Committee D .L OCT 2 Zo1s RAP:, �S:�: ?.-OPMENT . f •- - ? Parcels Town Boundary .+ Railroad Tracks 4V '�{ ! Buildings APProx Building Buildings Parking Lots Paved ed Roads 1) r� -A 1� .f 5 Paved Road � n Unpaved Road Bridge fff \ � ,v �•Paved Median Water Bodies IlA 44 Ih l ' `F `f�l� L y•` i J) {A \ t� i� � 1J � � •4y •, 4• ,' - i b4ap Printed on: io i 2oi w Lti y / 7/. 9 This map to for illustration purposes only.It is not Parcel Hues ❑ adequate for legal boundary determination or shown on this map are only grapblc Town of Barnstable GIS Unit Feet regulatory interpretation.This map does not representations of Assessor's tax parcels.They are 333 667 O an on-the•grouid survey.It may be represent not tree property bommdaries and do not represent 367 Main Street,Hyannis,MA 0260i reflect current Conditio in r�not accurate relationships to phyalcal objects on the map 308-862-4624 Approx.Scale:1 inch= feet Conditions,and may contain such sa balding lorat7nres.333 cartographic errors or omissions. gis@towmbarnsstable.ma.ns TOWN OF PROPERTY s r r ;n x- ' Legend BARNSTABLE Road Names i v .i.. - •�� r t S y w y `� F ADD y x Map printed on: io/17/2o19 This map is for illustration purposes only.nly.It is nut Parcel lines shown on this map are only graphic Town Of Feet adequate for legal boundary determination or representations of Assessor's tax parcels. Barnstable GIS Unit regulatory interpretation.This map does not represent not true property ��are o 21 42 an on-the-ground survey.It may be generMlzed, P Peon hips to boundaries and do not represent 367 Main Street,Hyannis,MA 02601 reflect current conditions,and m may not accurate relationships to physical objects on the map $08-8fi2-4624 Approx.Scale:1 inch= 21 feet cartographic errors or omissions contain �� building locations. ' gis@tOwn-barnstable.ma.us 1 1 1. t ''i�`Sy;;,r .�{i� r��'� r•.I..a�il 'r a..tr.I. - � �� i ,� � _'• l Vr , *461 IL - _ _ �• \' I Aip • -ti 11f16/2009 R - 1t • • r_. n - _ - ♦1 1• 1 10/17/2019 ShowAsbuilt(1700x2800) i TOWN OF BApRNSTABLE j LOCATION 23 i5 4ANeugh & SEWAGE/jl�, VILLAGE LIJ• prn cfa ble ASSESSOR'S MAP 6 LOT _ INSTALLER'S NAME G PHONE NO. SEPTIC TANK CAPACITY LEACk kNG FACILITY:(type) 2i f (size) NO.OF BEDROOMS_.I _PRIVATE WELL OR//PUBLIC WATER BUILDER OR OWNER h bd t/ 5 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 1 >o. `r j W ag i https://itsgIdb.town.barnstable.ma.us:8431/Home/ShowAsbuiIt?mp=216044&sq=1 1/1 _ 1 "`�" � CERTIFICATE OF LIABILITY INSURANCE 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 INSURMS),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,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 certifikate holder in lieu of such endonsement(s). PRODUCER NAME: Schlegel&Schlegel ins Brokers,Inc. PHONE 508-771-8381 34 Main Street A►c No: 508-771-0663 West Yarmouth,MA 02673 ADDRESS: schf insuran .com INS S AFFORDING COVERAGE NAIC s INSURED INSURER A: Travelers INSURER B• JAMES MCMORROW INSURER C: DBA JFM CONSTRUCTION 17 CIRCLE DR INSURER° HYANNIS,MA 02601 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 ALI,THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES._LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR TYPE OF INSURANCE POLICY NUMBER D C COMMERCIAL GENERAL LIABILITY LIMITS EACH OCCURRENCE j CLAIMS MADE OCCUR PREMISES j MED EXP one j PERSONAL E ADV INJURY s GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE j POLICY❑JECTPRO- LOC PRODUCTS-COMPlOPAGG j OTHER: : AUTOMOBILE LIABILITY COMBINED SW U $ ANY AUTO dell OWNED SCHEDULED BODILY INJURY(Per person) S - AUTOS ONLY AUTOS BODILY INJURY(Pet ecddent) j HIRED NON-OWNED AUTOS ONLY AUTOS ONLY PR(Per accident)j s a j UMBRELLA WB OCCUR EACH OCCURRENCE j EXCESS LIAB HCLA1MS'4AADE AGGREGATE j DED RETENTION j WORKERS COMPENSATION j AND EMPLOYERS,LIABILITY PER Y/N STATUTE E� A OFFIANY CEOR/MfMBER EXCLUDED? C E Y� NIA E.L.EACH ACCIDENT t: 100.000 (Manila"In NH) ASSlGH000148586 05/22/19 05/22/ZO- It yes,desail a under E.L.DISEASE-EA EMPLOYEE j 100.000 DESCRIPTION OF OPERATIONS bebw EL.DISEASE-POUCY LIMIT j so-000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Sctoduk,racy be attached If more specs is rewA" James McMorrow has elected not to be covered under his workers comp policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISION AUTHORED REPRESENTA O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD L xc�Cr����4i�iJ 5v�'36z 'L2SS � elFM CnnTS'i'IiIJCTiO`T RESTORATION-REMODELING- FINISH CARPERF'fRY � 17 CIRCLE DRIVE •AYANNIS,MA 02601 (508)737-6834 (� � II Pikk.�, ��iS CS � O(81a�J pj � PC6 2�6 5 its f\cl\ (a r�-�'� a�,�, � A (New �a IM; rry� F� �tub� O-ec po aw � � �`��ve vu-vv\� OA �A S {� L✓S �D �tC� o� � 1&0 `��r �� ��' ti'�l U i�rfQ yl � I ro`�- 4 /wr/c c�J 1HE Of ,&t11LD1A1G DFPr Application Number......&.-.1.77-3.6....... .......... ...... .. ... ...... ... • MABEL A(0 V 0. Permit Fee........ ...........Other Fee........................ 639.s rotv[v OF 8 Total Fee Paid............................................. 4RIVSr A BLe. :... ...... TOWN OF BARNSTABLE Permit Approval by ...... BUILDING PERAUT ..........p2 4 ...............Parcel....... ..................... APPLICATION Section 1 —Owner's Information and Project Location Project Address tn. Village ts* Owners Name—14 )1 C4 Owners Legal Address City ]Ae� State zip Owners Cell# 073' E-mail Section 2 -Use of Structure Use Group_ ❑ Commercial Structure over 35,000 cubic feet El Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 - Type of Permit F-1 New Construction ❑ Move/Relocate [:] Accessory Structure E] Change of use 0 Demo/(entire structure) -E] Finish Basement Ej Family/Amnesty El Fire Alarm Rebuild Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall EJ Solar El Renovation El Pool El Insulation Other-Spec Section 4 - Work Description AJ� T.Aqt iindsited- 1 1/I 5P01 R i i Application Number.................................................... Section 5—Detail Cost of Proposed Constructio 0v Square Footage of Project Z Age of Structure Dig Safe Number # Of Bedrooms Existing Total #Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors i ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom I Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane CI 'Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site) Setbacks Front Yard . Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 Application Number........................................... Section 9= Construction Supervisor Name l-,,� Telephone Number 73 7 Address l't✓'� City State Zip License Number License Type �piration Date Contractors Email o o r CG Cell # `�Gl 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.Attach a copy of your license. Signature Date Section 10 —Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number .Voxpiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors 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.Attach a copy of your H.I.C...16) Signature Date C� Section 11 —Home Owners License Exemption Home Owners 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 SIGNATURE Signa Date Print NameG VM(00✓y�'�Telephone Number Jy l� �,� zaw 1 E-mail permit to: Cv 5 W\o �. Last updated: 11/15/2018 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑r Fire Department ❑ Conservation For commercial work,please take your plans directly to the fire department for approval. Section 13— Owner's Authorization i L , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name �a Last updated: 11/15/2018 Town of Barnstable Buildin -� Post This Card So That it is Visible From the Street-'Approved Plans Must be Retained on Job and this Card Must be Kept aNttr'srAHLE -;. v� b' `�$ Posfed Until Final Inspection'Has Been Made. Permit or °39. Where a Certificate of Occupancy,is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-3504 Applicant Name: JAMES MCMORROW JFM CONSTRUCTION Approvals Date Issued: 11/01/2019 Current Use: Structure Permit Type: Building-Deck Expiration Date: 05/01/2020 Foundation: Location: 2355 IYANNOUGH ROAD/RTE132,WEST Map/Lot: 216-044 Zoning District: RF Sheathing: Owner on Record: PLIKAITIS,ROBERT&WILLIAM Contractor Name: JAMES MCMORROW JFM Framing: 1 CONSTRUCTION Address: PO BOX 280 2 WEST BARNSTABLE, MA 02668 — - - -Contractor License: 171522 Chimney: Description: Like for Like to deck, replace rot l , Est. Project Cost: $5,000.00 Permit Fee: $ 110.00 Insulation: Project Review Req: r Fee Paid: $110.00 Final: Date:'`I 11/1/2019 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. Rough Gas: All work authorized by this permit shall conform to the approved application and thetapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. 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.The Minimum of Five Call Inspections Required for All Construction Work:? Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Legend t •'" :x: . . Parcels Town Boundary #1955 Railroad Tracks Buildings �#.°2423 A - VJ Approx.Building .a � s t. k'.'.. 951 � ,r`�� �_ ''1 In Buildings rr. Painted Lines Parking Lots t ti Paved Unpaved .`_ #939 r` J Y Driveways V Paved j' Unpaved Roads •.,l 0 Paved Road Unpaved Road 1r Bridge #913 Paved Median Streams Y 'y� L #2.240 Marsh Water Bodies . `/ 'R X Y• ' c\ #2355 r; ,'\'. •` -� `•� mac:.,ti:'�:':1.... # #0 J ,f r' #2335 #2.245 Map printed on: 10/17/2019 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026oi 0 167 333 0 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: 1 inch= 167 feet cartographic errors or omissions. gis@town.barnstable.ma.us CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/24/19 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 NAME: Schlegel&Schlegel Ins Brokers,Inc. PHON o E 508-771-8381 FAX No: 508-771-0663 34 Main Street E-MAIL West Yarmouth,MA 02673 ADDRESS: schlegelinsurance@gmail.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: Travelers INSURED INSURER B: JAMES MCMORROW INSURER C: DBA JFM CONSTRUCTION 17 CIRCLE DR INSURER D HYANNIS,MA 02601 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR IT- PREMISES Ea occurrence $ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JE Q LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea acc dent ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY AUTOS ONLY AUTOS (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBER EXCLUDED? N/A ASSIGH000149586 05/22/19 05/22/20- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 D es, IPTIOe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) James McMorrow has elected not to be covered under his workers comp policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISION AUTHORIZED REPRESENTA V ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AFM COl1TSTl$UCTION i7 t'atCLE DRIVE •HYAAIIVIS,MA 02601 (508)737.6834 �o�81ar a 3 �s14) y P0, oo PC6 no✓L NA. - (a �r -4 Ppkm . � �uvu� � �ew�d✓�c ��is�+y� Dab. . CPA New -fccfoll (New ott::wo V\a( fcrrS 0U�h S {'rtcv�n� �S�eL'�S Vaek OVik�r tPik,5 erfqy Are auu�5 r46 ���� The Commonwealth of Massachusetts Department of IndushWAccidents Office of Investigations IF 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/plumbers Applicant Information Please Print Legibly i Name(Business/Organization/lndividual): Address: 1.1 , C 3� City/State/Zip: Phone#: Are yjW an employer?C k the appropriate boa: Type of project(required): 1.ETI am a employer with•_ 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for mein any capacity.acitY• employees and have workers' t 9. ❑Building addition [No workers' comp.insurance comp.insurance. r ed 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions ❑ �repairs or additionsh d i h ffi ocers have exercised their 1 L Plumb' r 3.❑ I am a homeowner doing all work myself.[No workers'comp. right of exemption per MGL 12.❑Roof insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13'�Other N Vt.— comp.insurance required.] *Any applicant that checks box#1 mast 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 hue 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 thepolicy andjob site information. ,//' Insurance Company Name: 6'(�✓� Policy#or Self-ins.Lie.#: ( Expiration Date: Job Site Address: City/State/Zip: l Attach a copy of the workers'compen ation policy declaration page(showing the policy number and expiration date). /� �r Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a U "l0 fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb ertify under the pains andpenallies ofperjury that the information provided above is true and correct Si ature: Date: 61 I 6 11 Pbo<;;�7 0�- -? 3:7—Zw--1-4 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 constrict 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-contractors)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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice 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 1-877MA.SSA.FE Revised 4-24-07 Fax#617-727-7749 www;maw.gov/dia MA Legend e ; • a. _ r�-•,.• ❑ Parcels Town Boundary Railroad Tracks Buildings e� Approx.Building ti ©Buildings ff � � Parking Lots Paved y t1 Unpaved Roads r 4I i 13 Paved Road Unpaved Road Bridge i !- z X bbY ■ Paved Median j' f rr •` /' j �i Water Bodies ram` CZ4 Map printed on: 10/17/201.9 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026oi 0 333 667 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: 1 inch = 333 feet cartographic errors or omissions. gis@town.barnstable.ma.us all • ` �c V� Legend r � , - • Road Names 46. 44 7. 355 do IL FT, �,J' •' 'fir. - ,# � :. * �r t a Qt .� _ _ sue.ate., y 1� � � r ",rr , •�. �r♦ ♦ � • �, �♦d� �.14, f�� ► of Ir � '-3 •.� � 17 .•, t�J -�� t l5 +' +► �1 �� r i r., ry.7t v. �srL'.c ►� - .�' w '�' 1� ',� r * a rya+ ►•' y> .. Map printed on: 10/17/2019 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026oi 0 21 42 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx. Scale: 1 inch= 21 feet cartographic errors or omissions. gis@town.barnstable.ma.us Details Page 1 of 1 Licensee Details Demographic Information Fuil Name: JAMES F MCMORROW wner Name: License Address Information ity: Hyannis tate: MA ipcode: 02601 ount : United States License Information License No: CS-098120 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 9/12/2019 Issue Date: 9/10/2011 Expiration Date: 9/10/2021 License Status: Active Today's Date: 10/29/2019 Secondary License Type: Doing Business As: tatus Change Reason: License Renewal Prerequisite Information No Prerequisite Information No Available Documents https://madpl.mylicense.comNerification/Details.aspx?result=fe6al 0e2-be39-4626-aa6d-... 10/29/2019 �j �j �t p Application Number. — 14- v 6. q ...................... + sARNSPA8L1r. i MAS& Permit Fee...,., .....I.. ..:..a ..........Other Fee,....................... a639• FD MA'S� TotalFee Paid............................................................... ...... TOWN OF BARNSTABLE Permit Approval b j..(�.. BUILDING PERMIT Mep.........a.f.. ..................Pareel............0... ..q..................... APPLICATION Section 1 —Owner's Information and Project Location Project Address �3 �� Village (,(){S� Owners Name 1 Owners Legal Address City_ State o4 Zip o Owners Cell# -737 Anz E-mail Section 2 —Use of Structure � q o Use Group ❑ Commercial Structure over 33,00 cubic feet ; ❑ Commercial Structure under 3 5,0 00 cubic feet Single/Two Family Dwelling ti Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Chauge of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ . Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify 1 Section 4 - Work Description T.Aat imrintrri- 11/1 Infll R Application Number.................................................... Section 5—Detail Cost of Proposed Construction Uv Square Footage of Project Age of Structure T Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑' MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage �❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom Water Supply ❑ Public ,0 Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 ! Application Number........................................... Section 9= Construction Supervisor Name J Telephone Number r-�—=— Address City 1 state,, Zip License Number License Type 12Ar T� L iration Date Q o2 Contractors Email Jrff (OV(\,Cell # Y7�7 3 7 � ,Y--` i 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 r aired by 780 CMR and the Town of Barnstable.Attach a copy of your license. /)l l l 4 Signature Date !/I I Section 10—Home Improvement Contractor Name Telephone Number Address ( City State Zip Registration Number Expiration Date �� 1 0 yC;�� I understand my responsibilities under the rules and regulations for Home Improvement Contractors 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.Attach a copy of your H.I.C. Signature Date U4 / ? Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 t 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. t Signature Date APPLICANT SIGNATURE Signa Date k�f77 i Print Name�J ��� �, d r�(,(„�Telephone Number c50a73 E-mail permit to: W�p� \ C 0 Last updated: 11/15/2018 i Section 12 —Department Sign-Offs I Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ . i Conservation ❑ For commercial work,please take your plans directly to the fire department for approval i Section 13— Owner's Authorization I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name f. i I Last updated: 11/15/2018