Loading...
HomeMy WebLinkAbout0071 MORGAN WAY r7 m©c- r� U 5 . r � v w i Town of Barnstable Building s SAWSMABM Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept Posted Until Final Inspection Has Been Made. .b Permit sp. 1 `1 Wit' Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Per Permit No. B-20-261 Applicant Name: Jonathan Whipple Approvals Date Issued: 01/28/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 07/28/2020 Foundation: Location: 71 MORGAN WAY,WEST BARNSTABLE Map/Lot: 174-001-066 Zoning District: RF Sheathing: Owner on Record: FALZONE, RICHARD 1&ANDREA B Contractor Name: JONATHAN N WHIPPLE Framing: 1 Address: 71 MORGAN WAY Contractor License: CS-,078683 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $5,636.00 Chimney: Description: Insulate attic, kneewall, common wall,garage ceiling and bulkhead Permit Fee: $85.00 ► ( Insulation: door. Install ventilation chutes,soffit vents 4x16,insuated bath Fee Paid: $85.00 D : exhaust hose 4" and home air sealing. 1/28/2020 Final: ate Project Review Req: o- pp �¢a� 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 fires't flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 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). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �N►—,,�+`' ��- S 5wr r �JES 6 N vA-FA SIN FAMILY A- $Ez=w 5EPrI C T41V_ 4.,(0 C1!�) °,o-G,Go GIB U5 G I Sop _PISPOSA P►L Z-Iv�v6ALr A�SrvlJt 5 I D E WA LL AREA �o SF 1 / 99 �7Xv5(=-A 2•0 BOTTOM AREA - I oo St~ TOrAL �E;16N = loP3 �, , `FarAL DAILY FLOr/ 4�0 L/Vpc�, .4, CO 1E2GaLATI ON RATE = I'► iN 4 M I�• B� GR.A►� /74or�r PE lock / ,% oil, k9gs / ��S�F�-_ �'<:•_ PETER "jeL 9 / SULUVAN I e.nxTn NAL -,!i`1 2. -'5 T. ii 12�1� �.-- l�oLE- s� ' "oPEW qb �= gg FG=f3"1 TF =90 LoAk -�...:rr�— ----w 7— —'ern'_ P Svaso�c. 2' ICJ✓ v C— Imo, DIST IN✓ ICI✓ Gt"' M1:-:D low ��✓ Irl✓ BoX ,�4AtL S�rlc ear; I SQua GAL g# TAN1= Ga}e.v6L wP�T w� r tt'' °F 1314_IVz Sir w,u�m kG, A� 5rzucrvQEs S sToaE Mvec TuaN a! vrel- sr(4c L Ze 1,4-Zo mAp n4 PGL I—!�a(, I CE Mr—I ED PL oT' 'P I co pesE -�NE1 aP PQvFI �. LG -�lo�i !�N ► 1 54Wr,{(.npvE L �D SGaLr _..__�_4, -4- DATI= , i�z I was 00 U)47w) I�rLoPos� _� PLAN �1=ERoJC.rr 1 CEP-TI FY 7�dT THE bw r-u.r w e— '90W14 HE!ZEON COM'pL S wlrµ T1df 51DEUIJE LoT' OP -bAzIMT*La TED ff\WI fl I U .T�E rGDOD Ir ji I - ----_-__ -✓n. l � L p�4F `�;IviJdr_ LAu� SueVe 5 115 Ff ;� IS NOT ��Alr� 0"•1 AN I�STL'Oti4El1T' � /�. 5URVe'-� A141p rNt ONSETS � 4DUI.X) u cr _0 o 0 EE[_, USCi'D Tb E5'FA*F_ I,k FW_o-pevTy uwlz5 51 Iz�lcu. MAzl, dPPLICANT, Cv UILAIIG Cv l4iC.. 7 � , o I r r-! m il J II E II - ,li I�I li 1, I �I I• ,i L—JO i ! �I ' ! I '1 W � I do ddo � i Q V IL -- - C N I. CD -i F- _o »a�" T'o�J:Sa �d > I I Y 2 0 W Lo u v iItooI' ;;Tj , II I l U1 I 2 > II L jl ® y1 I I i /• I I Vi n 4 Y � ® I 1qj 4 -LEE I � a. . RIOGE Saa1wIGL.e.S . ,`� - � =2�o f•1�2LGtA5 t:' °gip ' • i �G SEAL-TAB ASPWALT HOOF SHINGLES • /�3:' C'm A 'Pc_Y SHE.AT4IIMC- j .1�000:FUrL21NCs.�.Ko''O.0. 1.2"7941 E COW � �l2 _1%.0 SoFFIT "F.IN.1'.S AL"^'C.U.TTG2. 1-L.A DELL -'_VCN.T.Inle-_.DrLIP. E.rJGC.. ?/0"PV•{:..9U•�R.lOOR -Fy ET£ 30Amr> T�Top of • 2Y 1 O..(e�.,.16• � - -- 1 Cf, ]VIFIQO�`1• FP1�,IP C� � �' - -- •8' Yz-Stilt eTRotJr... A, \� L N -TA --.`��z�.sTuvti=Ole-o• C. '� I J S\ (o':.:_FIgtLEGLQ7 1N$uLATIOW . II '� 2y q �/2"'GA K'"PIN:...gM EATI••III.JG `—I f2 cYv a e..... ::.;: _..... L pn 3oA= FR,o0r Cv 1' ��Q__ _ 14'-d' ..\V.C.SHI.NCaIES �,�IOES It fiF c T2F6TRT�-$r l�l"pN"SIIJx%1 LL ---1 - -- 7' - --—•-" 6 3 4 4 z I.0 110 q,EpMt�' ?�, ��, I I 8"y-T'•B"Col.>C,rtr�JAu.S 1fw N���' �j .� � � QhPH/ILT.-f�/L/1'p•PZOO F• �I � �'\�`\�I�m �e°4�`e3• 1 ( .. '>�jELo\V� GTi.ADE� ri - �2•0- P --- � ?'C• � 12�0' ° 2• d 9 }" �'/2'r]CAN CouvnNs� `\1 -3•Ii'CIO Ncrt_9Lnoi.•1 - •fl 1(C _S.AYSIf7_E'__BU►Ur)INGs Co ING =C.C.NT ERV ILLE • ECAIF: I•`l7' PROM BY ORArm BY DATE: F_Q> (6 .......... ,_U j I I ou;. I F a y V� 1 3 o iAI 2' I bl. i w Oro I a iA it I I Si V •a�i 19 - I I I Ir � -- 1 t-y•oi i I . � 'o Cl I g m 4c� ,I tJ J M1k I I All I: M,,7t _J i I al i I i i f I�j N i p I i IP J 00.)4 a I. - a I : w _ i- I :.O iz/ : I � J:Q• ' d I r I rr Ll ".:�.=. -aM— pc 77. -C 9Sd3-v 7T11 20 - a v 2o'yl2'E.T.:SUN,�,eca . .IN GrZeA6js;- 8.•o. WALLPO02To"V-B 3e o� 4� r 41 6�.Su:.1 [troco-. 0AY W. I' 1 _ • CID t• — v YL. N 1 K IT G HEnI 1 t0 1 NALI-VINYL.. V\ I I' ❑ ,j _N'A Lt=-HOutL-:r70OR t YY �f• •Z . A I w M /`' n%'.•'� I .Henocrt--r-- �F.nin ILY .2o oit._ • � � i GatzAGf. ... �.. �-- PA.+T.�y _�. N. :CA�.Prs.eC IM v 'te- . 9 -cS�B:_F.r•.cS1.1 E-eT-.n.•..}[-Zfirc'naG—, y , .I 0 _- A.Wr> Min F N •Q r-IM SLY Z, 1 _a 4 :_LIB!\N G..Roe�•N �, . -M L� _ � I .g -'.G GRAG C�q;OOQfZ.—.._.__� IS'-cL' ..•�'-�' N i � � 0 ' •,2-Q � 't g•_'o• I ti-C�I 1.8 • _:..99r 58 `, }_.. ,.-.9..• g�o 1'L'-o• I IS._o..� 20•-0• 1 16`-ry. g• a• 12,-o. � i 4'-4" I 8'- 4" h:-4' 1�'-o' .'t�•_o. I I - _ dl I m _ ...... I C'i _BEOfZoo/A.2=- 'O -�To GG = •.:tMSTE2. g4TFl......_ I 0 _�.—.... A tL PCT- MTT CPR pcT r ` .n a _. 2•�. ?�N G 1 U 2'-6•.�VFUe.tr+_GtosCT a, . �I.'^ , .� E5 t-0lzooit.-3 JLPET V S a N. ......._....._.... .. 1 Town of Barnstable Expires 6 m s fro issu t Regulatory Services Fee = IAMSTABLE. MASS Richard V.Scali,Interim Director 059. �0 RFD MA'S a Building Division Tom Perry,CBO,Building Commissioner �(1N 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number i 7 j`"T ®D/ Not Valid without Red X-Press Imprint Property Address -7 ' [Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address nn,K -"Iu gA4 Q S Contractor's Name o C- Uu3 Telephone Number 50 S SO 01- LA-(p4,0 Home Improvement Contractor License#(if applicable) 12`6 j!S 7 Email:96U.yn I-W s-@ t C-0 04 Construction Supervisor's License#(if applicable) e( ( (p 7 ZWorkman's Compensation Insurance t� �.����� Check one: PERMIT❑ I am a sole proprietor ❑ I am the Homeowner NOV 10' 2014 YI have Worker's Compensation Insurance 0T0'A/N OF C DA Insurance Company Name L . A-t VU 1 D RNSTA P Y l 3�� � BLE Workman's Comp.Policy# LJLS 1S CS`� (� OS?-> Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 1qW_V,00 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red'S and 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. SIGNATURE 'C04 +, TAKEVIN D\Building Changes\EXPRESS PERN=XPRESS.doc Revised 061313 h 7 � x afllri� � ■ow O . +� ■ •o j y rC v ■USES rs W'1 LA I� r i � \ I � �� '�I i ( y, SI 1 S r f r ,L c �i � 1 f � � I �1 4,' "••: �`' �,� '�i y .,ti �: 4� J * * aaxxsrABM ,.� Town of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder �LOAi s ,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 Dfate Am V -1-,hPm �s Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. TAKEVIN MBuilding ChangesEXPRESS PERNEMEXPRESS.doc Revised 061313 a 2P )V0MM04M�M � LbwWIM Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration _ - Registration: 128957 Type: individual Ekpiration: 611412015 TM Oliver Kelly = Oliver Kelly 8 Rhine Rd Yarmouthport, MA 02675 = IIpdateaddrm and return card.Mark reason A I ab 9aM4M1 0 Address Renews! :] Employment . ...-__..—....- CJ�e��-�xu�r.��tntalH r�''_-'•{-las:acltc:e(F� .--• - - --- - . — _ .--- -•- ....---- QQ Office of CensnmerAMIM&Business 8qulation Licease or registration valid for individui use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gtstration: M957 Type: Office of ceasumerAOMrs i nd Business Regulation 1ration:'.--SK412015 incMdual 10 Park Plan ;Suite 5176 Bosun,MA 02116 aver Keliy fiver Kelly Rhine Rd. -- innouthport MA 02675 Undersecretary Not valid wlthoutAlpmatvre ' 19Massachusetts -Department of Public Safenr - Board of Building Regulations and Standards , License: CSSL-099167 OLIVER M IKEI LV • 8 RHINE ROAD . Yarmouth Part WA 02675 COl:11nI5slOrier 09/28/2015 ------------ -7t� s The Commonwealth of Massachusetts ?� Department oflndustrial 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 Le ibl Name (Business/Organization/Individual): Y a Address: 411� J 02��5 City/State/Zip: { Phone#:v o% 500t q(64, C) Are ou an employer? Check the appropriate box: Type of project(required): 1. I am a employer with 2- 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 me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LEI Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12TY'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 subcontractors 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. I �� Insurance Company Name: 3 — Policy#or Self-ins.Lic.#: Co rJ V�_) 2;t> 0 .7 Expiration Date: Job Site Address: W City/State/Zip:"S`,\ ( 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 Investi ations of the DIA for insurance coverage verification. I do hereby rti erdhe pains and penalties of er' ry th the information provided above is true and correct. Si a Date: Phone#: :5(c)ci, "L 0 4 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 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 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 doe license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone-and fax number:. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 11-22-06 . wrvw.mass.gov/dia A o CERTIFICATE OF LIABILITY INSURANCE DA,rE(MIw00/r Y, F5/1/2014 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 policypes)must be endorsed. H 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 endorseme s. PRODUCER DOWLING&ONEIL INS AGENCY INC NNAAME CT 973 IYANNOUGH ROAD PHONE Exile FAX A/C No HYANNIS, MA 02601 L ADDRESS: INSURERS AFFORDING COVERAGE NAIC f INSURER A: LM Insurance Corporation 33600 INSURED INSURER a: OLIVER KELLY INSURERC: DBA KELLY ROOFING 8 RHINE ROAD INSURERD: YARMOUTH PORT MA 02675 IN SURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 20051017 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. ILLTTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMSMADE OCCUR PREMISES Eaocwrrence $ MED EXP(Any one rson $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JECT LOC PRODUCTS-COMPIOP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE OMIT $ Ea accident BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED PeraocideM $ HIRED AUTOS AUTOS UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION WC5-31S-338804-033 12/28/2013 12/28/2014 S ER AND EMPLOYERS'LIABILITY Y/N 100000 ANY PROPRIETORIPARTNER/EXECU a IVE NIA E L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? � E.L.DISEASE-EA EMPLOY $ 100000 (Mandatory In NH) If yes,dlp'nou under E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS below _ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Sdredule,may be attadred If more space Is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state MA. This certificate cancels and supersedes all previously issued Certificates,only as they relate to workers compensation coverage. THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR OLIVER KELLY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE JERRY WALSH THE EXPIRATION DATE THEREOF, NOTICE VALL BE DELIVERED IN 110 KELLEY RD ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA 02601-1990 . AUTHORIZED REPRESENTATIVE LM Insurance Corporation ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014(01) The ACORD name and logo are reglstered marks of ACORD CBRT NO.r 20051017 CLIBST CODE: 1329955 Didi Dangas 5/1/2014 9:36:27 AM (PDT) Page 1 of 1 Assessor's Office 1st floor Ma ! 7 Lot Permit# r�-<79/0 Conservation Office 4th floor Date Issued Board of Health Ord floor En inecrin Dept. Ord floor House# � �� '®� °R � Planning Dept. 1st floor/School Admin.Bldg.): MAW Definitive Plan Approved by Planning Board ?� � ��r.I'9'��•��J!,�� �� �lyso39.,,� (Applications processed 8:30-9:30 a.m. & 1:00-2:00 p.m.) Mn-142d:A ' TOWN OF BARNSTA< �LF /`� Building Permit Application" "fie Pro'ect Street Address ?f !�l/ Village Fire District Owner -0 Address Telephonc -7 ( ' /Q 4l0 Permit Reouest: t!(' ��-�iu iCc� G�// / d all �7Y7 A'at -V- Zoning District P,C Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Appeals Authorization `'1 Recorded Current Use U //'' ,, Pro sed Use Construction T)N lVerld. / Existing Information DwellingType: Single Famil I/ Two family Multi-family ,� AQe of structure V Eal Basement type /�7,(lmd (.112f�iz,2(D Historic House n�L7 Finished Old King's Highway /V() Unfinished V Number of Baths No.of Bedrooms 3 Total Room Count not including baths First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached / Other Detached Structures: Pool f' Attached ZZX Barn None Sheds Other Builder Information Namc !",_.1.21 91-1kc Telephone number 7 7/-l0�O Address 6V4 �l S� License# ;9 Q 6-6 y S Home Improvement Contractor# Worker's Compensation # WC 1 31 Z 2 Z U C 7 'F D!3 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO&WEW 'Z�rde- a Pro'ect Cost 1d, aD D D�D�ss , Fee 3 SIGNATURE l DATE L '-l� BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) �"� BPERM T FOR OFFICE USE ONLY ADDRESS VILLAGE OWNER , DATE OF INSPECTION: gam. FOUNDATION Y y� FRAME INSULATION _ s FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING!!>, . ROUGH FINAL GAS: ROUGH FINAL , FINAL BUILDING: DATE CLOSED OUT: Z ASSOCIATE PLAN NO. ... .... ............. . MoR-6A1J 0 WAY ►s a s6 s.F. n h � i �9 2' l-DT I S7 OF 44 t#ECl1APi1 `N.\ �/ $/�a 2 O BAKTER .v ! !' . E3Ale N z C rZTIFY THAT THE E�16'TW& CEP.Ti Fish P&T PLAN F000 DATIOO SHovJ K3 NEMONN QDOMPLIS Lor-ATIO1J o CCA3-rMV IuJE 1W.SAWUS. W17-H T4C SIDEUI,E Auu SETBACV— SCALE- Wz lo' SATE o 4In j98 R�IRENe S C*J) G.rovO Ll of 9Atws PLAU (ZEFtRE/VCE Aldo IS klorT locATEp kxN ITH W A s KCJ A L l oT I S8 FL•OL- 439 Pr.-. I S FlooD NAZ.AR.:U Zot-W. BAr-TU � 1��E� LUG, 411i 112, LAND GN�cJ►IEEQ,s C. osTep-VIIL,E MASS. OFF 4ET4 FV-014 60ILDIN 6r$ SHOULD NOT BE USM To EsTABLIsH PAOPI`QV URES. APPbCAQT. BAYSIW&)ILDI&* Co. T--C- d TOWN OF BARNSTABLE 1 CERTIFICATE OF OCCUPANCY PARCEL ID 174 001 066 GEOBASE ID 38887 ADDRESS 71' MORGAN WAY PHONE W BARNSTABLE ZIP - LOT 158 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT WB PERMIT 32365 DESCRIPTION t PERMIT tYPE. BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS.--- Department of Health, Safety • ARCHITECTS: ,and Environmental Services TOTAL FEES: BOND ,$.Od Ok THE E CONSTRUCTION COSTS' $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE P tj1E * iA�N3TABLE, ; MASS. �► 1639. `0 � � { � Ep MA'S� _ •\ � BUI � V •�TO B ' i +I DATE ISSUED 07/27/1998 EXPIRATION DATE v i �J TOWN OF RO!/ <<p BARN TABLE . L�PLUMBING G PAI/> l� P" ril' TIC :'f!�{�" .�� l i.l ' �� (.}.:1 ���'�'• 1�. ii'iil.aH, 1 ai L.r . Ili If`i:5� ;'�� f.114��('� ,(`� ,4�F,y 'a ��.5,•. J13. . `1 If '41:1l.. ��' ,�1 '+'7 1' 1S I,Y L'..l:T•�,1 �V uN.xl�1' {. �� :a5 t1U V1 41A. 4 s 'T.� ���� ' :y �' ''' ''''r"' + • { n_ Department of Health, Safety and Environmental Services 0111611 ! -•rTUy ` �!J'�i `,�l ►c;. ill �t�' �/► * BARNSTABLE. • MAS& t i639. BUILDING DIVISION t THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.'S MINIMUM OF FOUR CALL INSPECTIONS REQUIRED ` FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST'BE RETAINED ON JOB AND W{1ERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE,A CERTIFICATE OF OCCU- (READY TO LATH). •PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOSTTHIS, CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 e A P� .3 !s!L°S� �kln15 �A(o� f *� �p 1 HEATING�rSPECTION PR ALS ENGINEERING DEPARTMENT OTHER: SITE P EVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HASAPPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OfCONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION.� - NOTED ABOVE. TION. 2 3(Q r I ' I • I Fps . I I • I I I I Vy I f t /.. � ' �. -ie� - ..... ,a,�• "+"cf'.�!�w .-•,mod"� + , Tlj cm CO o• N . C to /3 \ FG C!] CU - 00 . U , N CT p a a P-0 m y pq w cam. — .0 O C o ova a.a poC14n� F� A O. pGgG �. pry [J'] _• W O w OC] I.. C....! w m ai P a V O .N s PQ U A a 1-4'v � cn +.) Q N CI O Cn a, \)J A -moo\ /� (�//��om.monweal M of MaijacLietti e n 2apartment o��nc�u�tria[.�Iccic�enf� 600 f/VaiL.91on Sfreef James J.Campbell tDoaton, //'/ae.1achuiefff 021 1 1 Commissioner Workers' Compensation Insurance Affidavit 11 r2 /,i`9Av 7 8 U/c-A 1Av /AIC . (licensee/permittee) with a principal place of business at: C FV TE e-V t LLB ,414 (city/state/ZIP) do hereby certify under the pains and penalties of perjury, that: () I am an employer providing workers' compensation coverage for my employees working on this job. 1-113Ce-7Y MOT04L IA)S. a,eallP we/ 3ia ago /7� D l3 Insurance Company Policy Number () 1 am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: , 1.5 jC g i9;r7rV HF A S HF P Ts Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number () 1 am a homeowner performing all the work myself. t I understand that a copy of this statement will be forwarded to the Office of Investigations of the DIA for coverage verification and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S 1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this day of GCvtCt4a" 19 Q� Licensee/Permittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVFRACE INFORMATInM ('All • A 1 ,7_"7,77_ennn ven-r in , - SUBCONTRACTOR'S INSURANCE ENGINEEER: BAXTER & NYE ENG: (L) FIREMENS FUND - S30MXX80564866 (W) LIBERTY MUTUAL - WC1312595563023 WELLER & ASSOC: (L) NAT'L GRANGE MUT.- MSP45246 EXCAVATION & SEPTIC: ROBERT J. OUR (L) U S F & G - 1MP30109550901 (W) U S F & G - 771521695 DECO CONSTRUCTION (L) TRAVELERS - 660364K8342 (W) LIBERTY MUTUAL - 312446298044 FOUNDATION: BAYSIDE FOUNDATIONS: (L) COMMERCIAL UNION - ABR406267 (W) LIBERTY MUTUAL - WC1312201785044 WELLS: DENNIS SCANNELL (L) TRAVELERS - 660873E5627COF92 (W) WAUSAU - 151300062926 CELLAR/GARAGE FLOORS: MICHAEL BROWN: (L) AETNA - MP0023672849 FRAMERS: ROBERT DORRER: (L) TRAVELERS - W680526K991TIA9 (W) AETNA - 006CO023972416C MICHAEL DUFFLEY: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 MASON: SHERMAN, WAYNE: (L) COMMERCE INS CO - N60689 (W) WAUSAU INS - TO BE ASSIGNED ELECTRICIAN: CHAVES ELECTRIC: (L) HANOVER INS. - LHN2964649 (W) MISCELLANEOUS INS CO. - 0708878 91 1 PLUMB & HEAT: WHITELY PLUMBING: (L) TRAVELERS - 660365K1782COF9 (W) EASTERN CASUALTY - POLICY IN MAIL ALARM SYSTEM: BALTIC SECURITY : (L) FIRST FINANCIAL - FF0131 G400831 (W) COMMERCIAL UNION - CB0743379 CENTRAL VAC: VACUUM HOUSE: MERRIMACK MUTUAL - SBP1608045 i INSULATION: MAP INSULATION: (L) AMERICAN STATES - 02CC326435-3 (W) U S F & G - 7711099932 SHEETROCK: MEL REED: (L) WORCESTER INS - CB817530 (W) COMMERCIAL UNION - CBH557387 INTERIOR TRIM: DAVID'S REMODELING: (L) COMMERCIAL UNION - NB F821442 M & R CARPENTRY (L) MARYLAND INS. GRP- SCP30235965 (W) CIGNA PROP & CAS.- C80049997 OAK INSTALLER: ROBERT BUDDEN: (L) NORTHERN ASSUR. - NBF528652 PAINTING: CAMPBELL PAINTING: (L) TRAVELERS - 1680251K4083COF (W) AMERICAN POLICY - WCC 186604 GARAGE DOORS: ALL CAPE GARAGE DOOR: (.L) U S F & G - BSC14667590301 (W) COMMERCIAL UNION - CBH573757 STORMS & GUTTERS: ALUMINUM PRODUCTS: (L) AETNA - MPOO21014146 (W) AETNA - JC89258880 OAK FINISHER: AMERICAN FLOORS: (L) TRAVELERS - 680 342W754-0 CARPET, VINYL & TILE: CARPET BARN: (L) VERMONT MUTUAL - SBP6507393 (W) PHOENIX INS. - 6NUB476J652794 TILE INSTALLER: TONY AVERINOS: (L) ASSURRANCE CO. - CFP26528977 (W) HARTFORD FIRE - 77WZCY2409 WIRE SHELVING:- CAPE COD CLOSETS: (L) U S F & G - BSC146983441 APPLIANCES: KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098 (W) HARTFORD INS CO - 77WZNB1603 MIRRORS & SHOWER DOORS: L & M GLASS: (L) COMMERCIAL UNION - CBR409003 (W) U S F & G - 0071439933 LANDSCAPE & SPRINKLER: COY'S BROOK: (L) COMMERCIAL .UNION - ABR345850 (W) CIGNA COMPANIES - C41138178 DRIVEWAYS: NORTHERN SEALCOAT: (L) MARYLAND CASUALTY- EPA18716945 (W) THE PHOENIX - UB387K530 A