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HomeMy WebLinkAbout0101 MAPLE STREET Ilk x�� d NO. 152 1/3 ORA ESSELTE .� f REC6pS�E 0/9%7 o 7 �]k 3 i,� 4� 1 . 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 M"9 i63¢ 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-19-2145 Applicant Name: Isaiah McCarteny Approvals Date Issued: 07/12/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 01/12/2020 Foundation: Location: 101 MAPLE STREET,WEST BARNSTABLE Map/Lot: 132-029 Zoning District: RF Sheathing: Owner on Record: Isaiah McCarteny Contractor Name: Framing: 1 Address: Contractor License: 2 W. Barnstable, MA Est. Project Cost: $12,000.00 Chimney: Description: Remodel kitchen and bath Permit Fee: $ 111.20 replace roofing shingles in kind Fee Paid:. $ 111.20 Insulation: Date: 7/12/2019 Final: Project Review Req: Plumbing/Gas Rough Plumbing: Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Plumbing: 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. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Electrical 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) 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 Final: 101* MOLL ST W. 9APJYSTA bt'E (SA IA H McCAeTdVEY . i�t�ch'2c� / hatti : ren��c�eL. Ih eiciS+ihc, S•(JcnC� � • tZKT w G L M LIN D ' n Col Vv c . N ul) ` Q�- = �, Oa - 0 _ cl , jA �` W The Commonwealth of Massachuseta Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Bnflders/Contractors/Blectricians/Plumbers Applicant Information i Please Print Legibly Name(Business/Orgmization/Individual): Address: 10( M A�V 5iff-e-i City/State/Zip: W , -4-rn 5+; a b 1 E m A• Phone M 2 00 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 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 S. ❑Demolition working for me in any capacity. employees and have workers' 9. El Building addition [No workers'comp.irmminCe, COMP.insm'ance.t /r��] 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 infonnation. 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$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 hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 7 11 // T Phone# 0 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 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 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-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies alp 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 drat 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 firture 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 bran 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 Qfee 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 Application Number.. ....... ................. ..... .. . . ... . .... . ........ ELAPIMABLF, KAS& Permit FeJ..!.J.1.:.�"...............other Fee:....................... s639. !!J Total Fee Paid............................ !Q TOWN OF BARN Sr rAftE.12 bo Permit Approval by..ab....................On...7— a, 04 < -"efi 4�i BUILDING PERMITS4=" C'O JS C) � ., U— Map.......!......a Parcel............................................. APPLICATION --J' c'a" 5 ea ;-51.1 Section 1 — Owner's Friformation and Project Location Project Address i0t MANE �->T, Village W, OwnersName. I-S&-OLMccartn-e- � Owners Legal Address City .Wt YR Mou+-I State Yn a , Zip Owners Cell# 5-0 -7 3 7 2-M 0—E-mail Section 2 —Use of Structure Use Group_ ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 — Type of Permit ❑ New Construction FJ Move/Relocate [] Accessory Structure E] Change of use El Demo/(entire structure) El Finish Basement El Family/Amnesty El Fire Alarm Rebuild El Deck Apartment' El Sprinkler System ❑ Addition ❑ Retaining wall F] Solar Renovation ❑ Pool El Insulation Other—Specify, Section 4 - Work Description tQdJQ e4- h/J..) 1 • J Last undated: 11/15/2018 Application Number..................................................... Section 5—Detail Cost of Proposed Construction 'iz Square Footage of Project 2 140 �nil Age of Structure A D ORJX 2009A ,a 1d Dig Safe Number # Of Bedrooms Existing q 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 1 ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom 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 ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation C Within or adjacent to a wetland,coastal bank? Yes ❑ No t Section 8—Zoning Information It Zoning District 14 Z Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site) Setbacks Front Yard Required Proposed i Rear Yard Required Proposed 1 Side Yard Required Proposed i 1 Has this property had relief from the Zoning Board in the past? El Yes 0 No • i i Last updated: 11/15/2018 1 Application Number........................................... Section 9- Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell # 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 r 'Date" �'.. . Section 10l—Home,Improvement Contractor',; Name ' a Telephone Number Address City State Zip Registration Number Expiration 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... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: i6aobG 4Y)G 4 0:�M Telephone Number 6 7 Cell or Work Number 5DS y Co Sq 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 C'MnR�and the Town of Barnstable. Signature /I' Date 71 f ( 1`j APPLICANT SIGNATURE Signature ! CC/� Date � 1 y Print Name ��1cE h I Y1 G Cce t' ec� Telephone Number S �� 60-S-1 E-mail permit to: lM �CGr+-h e_ l Z*-2 0 m�1 CCNY1 Last updated: 11/15/2018 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval, Section 13 — Owner's Authorization i i I, I&CO&h (Yl CcR,t -e�j , as Owner of the subject property hereby authorize -O ffl� "dam `-rr^r6 A .A KA to act on my behalf, in all matters relative to work authorized by this building permit application for: 10( m L S 'rfeJ_, W r �rn`s+rx ke, i MA 026 3,Z (Address of job) Signature of Owner date :5alah mcCAC+V►f_N Print Name I {i { i i i Last updated: 11/15/2018 Application number.. ................ ' .� mac' L , Fee............... ......... .................................. po EMMSTAz'e" ��,��r r Building Inspectors Initials... ..p....... Date Issued......'-. ... ...- !.. ............................... n Map/Parcel......1.....:.............1./............................... TOWN OF BARNST"LE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 10 M G n lip, `7e+ a cornsb+& R , NUMBER STREET VILLAGE Owner's Name: f5 M C Phone Number-0 b 2 3 4 00 S Cf Email Address: MCCa r+-ne Z 7 9 m AJ . an Cell Phone Number -- v Ll Project cost$ 2.i 5 Check one Residential_/ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: I TYPE OF WORK dSiding Windows (no header change)#_I_0 Insulation/Weatherization E-1 Doors(no header change)# Commercial Doors require an inspector's review E-1 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION a Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* I ' 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. Purpose of Event 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 Fuel source being used LP tank 20 lbs. or> Yes No , if yes, a gas permit is required. Natural Gas Yes No , if yes,a gas permit is required. 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: to CA,-a h M -a((-f n t1A Telephone Number SO $ Z4IA 0059 Cell or Work number sa yw�_ 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_4Date 12 g ( I G/ APPLICANT'S SIGNATURE Signature - L Date( (I All permit applications are subject to a buil `ng official's approval prior to issuance. 1 The Commonwealth of Massachusetts Department of Industrial Accidents = Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): llyi i h M CC CL 012 L(4 Address: 101 VYlCal QQ.k StjL-�P!A 02 lob 8 City/State/Zip: w, BaM1 bLk,. MA Phone #: 5b S Z q 00,5q 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. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' # 9. ❑Building addition [No workers' comp.insurance comp.insurance. 10.❑Electrical repairs or additions _fequired.] 5. ❑ We are a corporation and its P 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$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 hereby certify under the p/ai1ns�and penalties of perjury that the information provided above is true and correct Signature: oQ Date: I 7-9 Il� Phone#: J'`D g 2� L( 0 0 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. i 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-contractors)name(s),address(es)and phone number(s)along with their certificates)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 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 Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia 9'1Qd1SN8V9 A0 NM01 9 t AON Town. of Barnsta ble *Permit# WD Expires 6 mo . from issue date. S3Hd7X Regulatory Services Fee r�ss Thomas F.Geiler,Director. i639. `0� Building Division Tom Perry,CBO,•Building Commissioner 200 Main Street,Hyannis,MA'02601 www.town.barnstable.ma us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property.Address r /Residential Value of Work :'� �� Minimum fee of$35.00 for work under$6000.00 t Owner's Name&Address l G•4 I c ��: Z t,-' (l j/< , .. Telephone Number Contractor's Name (( - Home Improvement Contractor License#(if applicable) A b �` Construction Supervisor's License#(if applicable) 6 0 ,`3 ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name C S � o f c'Ct r C Workman's Comp.Policy Copy of Insurance Compliance Certificate must accompany each permit. _ Permit Request(check box) /A✓ �Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red Sand.inspections required. Separate Electrical&Fire Permits required. .: - *Where required: Issuance of this permit does not exempt compliance with other town department regulations;i.e:Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter.of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. j SIGNATURE. J .?axe Commonivedfit of Massachusetts Department of Industrial-4ccidents Office of Invesfigafions 600 Washmpon Street Boston,MA #2111 . rwr W.jnass.gvv/din Workers' Compensation Insurance Affidavit.Buiders/Contractors/Electric ans/Phimbers. Ap licant Infnrmafaon Please Print "biv Address: y e City/State/Zip. (�) �e,.��' Phone## �- Are you an employer? Check he appropriate box: Type;of project(required): 1.Xemployees I am a employer with .4. ❑ I am.a general contractor and I 6- ❑New constrwtioo (fag anro_r -time)-* have hired the gubJcon#rachm 2.�I am a sole praprie�Goi crrpartz:es- listed on the attached sheet; 7. ❑Remodeling ship.and have no employees .These sub-contractors have g_ 0 Demolition Svod3ring for Mein any capacity. employees and have worms' 9. ❑Building addition [Nb workers' comp.insurance ce comp-•,,�*ce J required.] 5. ❑ We are a coaporation.and its 1 D.❑Flectncal repairs or additions 3_❑ I an a homeowner doing•all work officers have exercised dwir 1I_❑Plumbing repairs or additions myw1f [No workers'camp- right of exemption per MGL 12❑goof repairs T / insurance required.]T c. 152,§1(4� and we have no �� fi �q I. P C j la o workers' 13.0 Other comp.insurance required:]: *Any apphcard that chetm box#1 mnst also fMout the section below showing their wookers'compersaation policy infor=tim 7 Homeowners wba submit this af5dsvd infficatmg they am doingr aR arat sad then Lire outside coat=mrs mast submit anew affidavit indicating such ICon mcmrs that check this boo[must attached an additional sheet dwwing the name of the sib-cmd acters and We whether or not those entities have employees. Ifthe sub-contractors bzve employees,they nnisi:Provide their markers'camp.policy number. Iam an employer that is prmitling workers'compensadan in=rance forWily eng7&yev& Below is the p&ficy and job site. informadom Insurance Company Name: e S^•e�� Policy*or Self ins.Uc.# I1✓C- —-1-0 " � `C1 d9 C CI Expiration Date: / 1 Jab Site Address` �� ( /"a (� S' �✓ �/,�`<r1 City/State/Zip: 6 d 6' b 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 tine up to S1,500.00 andlor one-year imprisonment,as well.as civil penalties in the foam of a STOP WORK ORDER and a fore of up to$25O_6O a day against the violator.. Be advised that a copy of this statement may be forwarded to the Office of IM.estigations of the,DIA for insurance coverage verifrt�tion_. ' I do Hereby cerhfy xttrdar th.s pains andpenattres ofperjury drat the informdion pi m ided��a``bova is an correct 5i Bate: Phone u�- .0,yciul Ilse only. Do not write in this anal,to be coMFteted by citj'or taim officiat City or Town: FerniipUcense At Issuing Authority(circle one): 1..Board:of Health Building Department:3.CitylI own Cleric 4.£Iectricsl Inspector 5:Ph�mbmg Inspector .. . ., _. - � i 3 ( � Priscilla J. Wrenn 101 Maple Street West Barnstable,MA 02668 Pjw101@a,comcast.net 508-280-9811 November 7, 2012 Richard P. Cazeault Jr. 198 Five Corners Road Centerville,MA 02632 Dear Rich: Enclosed please find a signed copy of the proposal for the Front Main House roof at 101 Maple Street, West Barnstable. Also enclosed please find check# 155 in the amount of$1,100.00 as a deposit for this work. I'd like the new shingles to be a dark grey color—not with any orange tone to it. Thanks again—I'm really looking forward to having this work done! Best- Priscilla Wrenn PROPOSAL Proposal No. 12-782 October 10,2012 Wrenn Work to be performed at 101 Maple St W.Barnstable Ma 02668 We hereby propose to furnish the materials and perform the labor necessary for the completion of: ROOF REPLACEMENT (Front of Main House) 1. Remove existing shingle roof 2. Replace any rot or damaged plywood as necessary 3. Install new aluminum drip edge 4. Ice&Water barrier first 2k all skylights and penetrations 5. Cover roof with 15 lb felt 6. Re-roof with 30 yr architectural shingle 7. Install Cobra ridge vent 8. Flash all pipes and penetrations 9. Remove all rubbish from project Labor and Materials $2,200 All material is guaranteed to be as specified,and the above work to be performed in accordance with the specifications and completed in a substantial workmanlike manner for the sum of Two Thousand and Two Hundred Dollars $2,200 with payment as follows: One Thousand and One Hundred $1,100 due with acceptance of proposal and One Thousand and One Hundred $1,100 due upon Completion Respectfully submitted, Richard P. Cazeault,Jr. HIC#168607 CSL#100393 198 Five Comers Road Workmans Comp and Liability with Centerville,MA 02632 Mcshea Ins. Ost. MA (508)420-5482 Acceptance of proposal#12-782 The terms and conditions are satisfactory and are accepted. You are authorized to do the work as specified. Payment is outlined above. -------------------------- -------------------------------- Si ature Date - \ Vince o[t onsumer n ie�ro„«;nu�uca� License or regist,,k Lion valid for individui use only HOME IMPROV1VEMENT CONTRACTOR I f before the expirat;on date. If found retull n to:• - - Registration: 1 1,68607 E Type Office of Consumt;r Affairs and Business!Regulation Expiration: 318/203 Individual i 10 Park Plaza Suite 5170 Boston,MA 02116' 21 ARD P CAZEAWLT,JR Th (CHARD CAC�Ji R ' ?98 FIVE CORN li' / CENTERVILLE MA y Uuc' Mere a Not lid without signature Massachusetts -Department of Public Safet' i Board of Building Re ulati0ris a y 9 and Standards_ '•.:�� Cunstructiun Super,-isur License: CS-100393 RICHARD P CA� EADLT JR 198 FIVE C012NERS RD CENTERVIhLE rblA �02632. =, Commissioner Expiration,.'i 02/03/20141',. 1 i REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure (section 224-3) or already foreclosed for which possession has been taken(section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law, please state the reason(s) and complete section 1 (property information) and the first paragraph,of —i c) section 2 (foreclosing party, court, etc. and foreclosing party representative, l;.u'tnot other representatives and attorney) so that the Town can review the exemption and ' ate its - records: J n Section I —Property Information R� Property Address: 101 Maple St,WEST BARNSTABLE,MA 02668 Assessors Map#: Map/Block/Lot: 132/029 Parcel#: 132029 Land area and description Sqft: 2,533 Building(s) description and contents Single Family Residence,Year Built: 1740 Occupied: Occupant(s)(if borrowers so state and include name(s)) Wells Fargo Bank,National Association,as Trustee for Securitized Asset Backed Receivables LLC Trust 2005-FR2 Mortgage Pass-Throuah Certificates-Series 2005 FR2 coo Alfisource solutionsIncmir Shaikh asset Manager 866 952 6514 YPR@altisource.com/REOCodeviolations a@altisource.com Phone: emaill: other: Vacant: Date: 03/30/2018 Anticipated Length of Vacancy: Last occupant(s))(if borrowers so state and include name(s)) Phone: email: other: Has possession been taken If so, please explain and complete and file the maintenance and security plan form(unless exempt as stated above) Section 2—Foreclosing PgM Information Foreclosing Party (full name/title) Foreclosure Case Court: Docket# Date filed: Current Status: Foreclosing Party's representative(s) for property (entry, management, repair, etc.)(name, title,): Company (if different from foreclosing party): Address: Phone: email: other: If an exemption is claimed,please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure,please so state and do not complete contact information(i. e. "none" or"see above")). Wells Fargo Bank,National Association,as Trustee for Securitized Asset Backed Receivables LLC Trust 2005-FF Name,title, other: Mortgage Pass-Through Certificates,Series 2005-FR2 Go Altisource Solutions Inc-Samir Shaikh-asset Manage Company (if different from foreclosing party): Address: 1000 Abernathy Road Northpark Town Center, Building 400 Suite 200 Atlanta GA 30328 Phone(s): 866 952 6514 email(s): uPR@altisource.com other: Name,title, other: Company (if different from foreclosing party): Altisource Solutions, Inc-Darren Wisniewski(Waltham Resident) Address: 1000 Abernathy Road Northpark Town Center Building 400,Suite 200,Atlanta,GA 30328 617 728 6130 Phone: 4Q7 719 3930 email: Darren.Wisniewski@altisource.com other: Please mail correspondence to Atlanta office,Darren is local to address property conditions and emergency matters. Attorney representing foreclosing party Korde and Associates P C-Foreclosure Attorney Firm name (if different from attorney's name): Address: Phone(s): email(s): other: I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. t' fV Date: Name: Title: a 5S�4Q r/l yv�, "tr, 0 I i i I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner, Town of Barnstable I� REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure (section 224-3) or already foreclosed.for which possession has been taken (section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law, please state the reason(s) and complete section 1 (property information) and the first paragraph of section 2 (foreclosing party, court, etc. and foreclosing party representative, but not other representatives and attorney) so that the Town can review the exemption and update its records: Section 1 —Property Information Property Address: 101 Maple St,WEST BARNSTABLE,MA 02668 Assessors Map #: Map/Block/Lot: 132/029 Parcel #: 132029 O Land area and description Sgft: 2,533 Building(s) description and contents Single Family Residence, Year Built: 1740 N .. Q7 w M Occupied: Occupant(s)(if borrowers so state and include name(s)) Wells Fargo Bank,National Association,as Trustee for Securitized Asset Backed Receivables LLC Trust 2005-FR2 Mortgage Pass-Through Certificates.Series 2005-FR2 c/o Altisource Solutions Inc-Samir Shaikh-asset Manager 866 952 6514 YPR@altisource.com/REOCodeviolationsCaltisource.com Phone: emai other: Vacant: Date: 03/30/2018 Anticipated Length of Vacancy: Last occupant(s) )(if borrowers so state and include name(s)) Phone: email: other: Has possession been taken If so, please explain and complete and file the maintenance and security plan form (unless exempt as stated above) Section 2—Foreclosing Party Information Foreclosing Party (full name/title) Foreclosure Case Court: Docket# Date filed: Current Status: Foreclosing Party's representative(s) for property (entry, management, repair, etc.)(name, title,): Company (if different from foreclosing party): Address: Phone: email: other: If an exemption is claimed, please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure, please so state and do not,complete contact information (i. e. "none" or"see above")). Wells Fargo Bank,National Association,as Trustee for Securitized Asset Backed Receivables LLC Trust 2005-FR2 Name, title, Other: Mortgage Pass-Through Certificates,Series 2005-FR2 c/o Altisource Solutions Inc-Samir Shaikh-asset Manage Company (if different from foreclosing party): Address: 1000 Abernathy Road Northpark Town Center, Building 400 Suite 200 Atlanta GA 30328 Phone(s): 866 952 6514 email(s): VPR@altisource.com other: Name, title, other: Company (if different from foreclosing party): Altisource Solutions,Inc-Darren VWsniewski(Waltham Resident) Address: 1000 Abernathy Road Northpark Town Center Building 400,Suite 200,Atlanta,GA 30328 617 728 6130 Phone: dm 7391910 email: Darren.Wisniewski@altisource.com Other: Please mail correspondence to Atlanta office,Darren is local to address property conditions and emergency matters. Attorney representing foreclosing party Korde and Associates P C-Foreclosure Attorney Firm name (if different from attorney's name): Address: Phone(s): email(s): other: I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 o t de of the Town of Barnstable. i0i AU-1 Date: " Name: ` Title: i I I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner, Town of Barnstable r I REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure (section 224-3) or already foreclosed for which possession has been taken (section 224-` 4). Please file the original with the Building Commissioner and a copy with Ule Chief of the Fire District in which the property is located. CD W o � If you claim you are exempt from registering under Massachusetts law, please s.ate the Ln reason(s) and complete section 1 (property information) and the first paragraph of section 2 (foreclosing party, court, etc. and foreclosing party representative, but of other' representatives and attorney) so that the Town can review the exemption and up ate its records: Section 1 —Property Information Property Address: 101 Maple St,WEST BARNSTABLE,MA 02668 Assessors Map#: MapBlock/Lot: 132/029 Parcel #: 132029 Land area and description Saft: 2,533 Building(s) description and contents Single Family Residence, Year Built: 1740 Occupied: Occupant(s)(if borrowers so state and include name(s)) Daniel Adams c/o Ocwen Loan Servicing LLC-Judy Credit Phone: 800-746-2936 email: VPR@altisource.com/REOCood,ee olations@altisource.com Vacant: Date: Anticipated Length of Vacancy: Last occupant(s) )(if borrowers so state and include name(s)) Phone: email: other: Has possession been taken If so,please explain and complete and file the maintenance and security plan form(unless exempt as stated above) Section 2—Foreclosing Party Information Foreclosing Party (full name/title) Foreclosure Case Court: Docket# Date filed: Current Status: Foreclosing Party's representative(s) for property (entry,management, repair, etc.)(name,title,): Company (if different from foreclosing party): Address: Phone: email: other: If an exemption is claimed,please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure,please so state and do not complete contact information (i. e. "none" or"see above")). Wells Fargo Bank,National Association,as Trustee for Securitized Asset Backed Receivables LLC Trust Name,title, other: 2005-FR2 Mortgage Pass-Through Certificates,Series 2005-FR2 c/o Ocwen Loan Servicing,LLC-Judy Credit Company (if different from foreclosing party): Address: 1661 Worthington Rd. Suite 100, West Palm Beach, FL 33409 Phone(s): 800-746-2936 email(s): PropegRegistration@ocwen.com other: Name,title, other: Company (if different from foreclosing party): Altisource Solutions, Inc-Darren Wisniewski(Waltham Resident) Address: 1000 Abernathy Road Northpark Town Center Building 400,Suite 200,Atlanta,GA 30328 617 728 6130 Phone: 407 739 3930 email: Darren.Wisniewski@altisource.com other: Please mail correspondence to Atlanta office,Darren is local to address property conditions and emergency matters. Attorney representing foreclosing party Korde and Associates P C-Foreclosure Attorney Firm name (if different from attorney's name): Address: i Phone(s): email(s): other: I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Name: Title: I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. i Date: Building Commissioner, Town of Barnstable 3 I L Assessor's offioe (1st floor): / 9 �/ FTMET Assessor's map and lot number ....�3g........�o�.��, �'1`' Quo o�` Board of Health (3rd floor): 3 p n' "T� o"95 �.N Sewage Permit number ................ �3•P SEPTIC SYSTEM MUST •••�•. �•�•••••••••,••... INSTALLED IN COMPLIA 6Hd9TADLE Engineering Department (3rd floor):. /o� WITH TITLE 5 �°°aiF.'s IL b 9�a. � 3 �9 House number ......................................... ... ��.................. ENVIRONMENTAL CODE APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN REGULATIONS TOWN OF BARNSTABLE BUILDING -- INSPECTOR APPLICATION FOR PERMIT TO .....:...... .�:...� . ......... .... .. ................................ r p v TYPEOF CONSTRUCTION ...........11�i .S,-:.....................................................:................................................. �o.....-..�C. ............19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following informati n: Location ........./L/. ............ � ................ ........�L5 ................ .... ... ..� ..................................... ProposedUse .................1 ...........� . . ..,........... ..,........./•••crJ`lr�. ......................................... ZoningDistrict ...........................�...... ...............................Fire District .............................................................................. Name of Owner .. ,.Cleo....... ... ...............Address .... ......:. ,�. ... .. �o>✓... .,�. , .. Name of Builder ... . ./ ........Address ... . . Nameof Architect ..............................Address .................................:.................................................. ` C� ........................Foundation ..... .........Number of Rooms ............:......d Exterior ............ ,....................Roofng ............:........... Floors ................... �........................................................Interior ,�. Plumbing ............ �. Heating d. . ...... Fireplace L 4/.ie.:...............................Approximate Cost ................ Definitive Plan,Approved by Planning Board ________________________________19_______ . Area ...... �� Diagram of Lot and Building with Dimensions Fee . SUBJECT TO APPROVAL OF BOARD OF HEALTH 4,0� 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. P , Name . ... ....................... Construction Supervisor's license .................................... __ 'A T - LYNCH, LAURA \ No...30114. . . . . .Permit for. ,Swimming.Pool " . . .Add.t4.Dc����lmg,�.Siugle .Family. . . � _ Location. ,jgj .Mapie ,Street . , . . . . . . West Barnstable Owner. . . . .Laura .Lynch . . . . . . . . . . . . . . . . Type of Construction. . , Frame . . . . . , , , Plot.. . . . . .Lot. . . . . . . . . . . . . . . . . . . . ------------------------------------- Permit Granted. , , October. 29.. -. , 19 85 Date of Inspections� /77 47 19 Date. Completed. . . . . . . . . . . . 19 R E� -i Assessor's offioe (1st floor): T E TOE Assessor's map and lot number ....1..::.+°................j...... �( J( ? Board of Health (3rd floor): 3 e56_ j I I-I -T,�vN � E ) %6 Sewage Permit number ........................................................ �5 l� 1 BAWSTABLL Engineering Department (3rd floor): oo NAM o 9- House number y / e,a owl 3P 0,- APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......... f:: .............r' l.!. '`w? ...... ` /;1,'.:.y:.. ....:r .U..;;!�� ................ I V � TYPEOF CONSTRUCTION ........... ±? 1� :..................................... ................................................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:, Location ...... r%...vi? ..... ............. ......... ........................................ Proposed Use . .4,-t-isvyi..r,, .........: nr�.j�� © ZoningDistrict ........................................................................Fire District .............................................................................. r � _ Name of Owner .. ,1,'!2c!° Z-41.?./' ...................Address /! -�� f�P C .....d ...:::...... . ,..� �. v Name of 'Builder ?r'........Address ...x:y..... �.p ?...r.�%.. Z !...... .`........ i� r" Nameof Architect .............. . ...........................Address .................................................................................... Number of Rooms ................... ..:................................Foundation ......... . :��f ���1�f %-e. .......... . ..... ............................... Exterior ............'. `............ Z. .......................Roofing ..................�. P!. ..a; .. Floors ................... .......................................................Interior .........� A" ? )� ...................... ........................ ...................... ' e - Plumbing �r�,e Heating ............................................. g ..................... ............................................................ Fireplace // �T < .......Approximate Cost ................ ...: ....�....... .� �' .. Definitive Plan Approved by Planning Board ________________________________19________ . Area ..�........��'�.�:. `........... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r I 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 ....�::�>.. ' s � f- 4c Y � H Construction Supervisor's License .................................... i LYNCH, LAURA A=132-029 No ... Permit for AlKimming..)MI21 n._in ..P .0 Add to, Dwelling/ Single Fa ii1y ............................................................ ............. Location .... ... ...... .............. . .....................West' Barnstable ........................................ ................. Lynch Owner ..........Laura... ............................ Type of Construction ..........Frame................................ ............................................................................... Plot .............................. Lot ................................ October 29,.......... . 86 Permit Granted .......................... ... 19 Date of Inspection ....................................19 Date Completed ......................................19 6-0