HomeMy WebLinkAbout0385 MITCHELL'S WAY z
i
i
i
I
i
Town of Barnstable Building
xn P t This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept
KAS& Posted Until Final Inspection Has Been Made.
t65q. Permit
1 1
k Where a Certificate of Occupancy is Required;such Building shall Not be Occupied until a final inspection has been made. I
Permit No. B-20-2999 Applicant Name: RIVERA,AIDA& MAURO TRS Approvals
Date Issued: 10/15/2020 Current Use: Structure
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 04/15/2021 Foundation:
Location: 385 MITCHELL'S WAY, HYANNIS Map/Lot: 291-014 Zoning District: RB Sheathing:
Owner on Record: RIVERA,AIDA& MAURO TRS Contractor Name. �,.. Framing: 1
Address: 34 STRAWBERRY HILL ROAD Contractor License: } 2
CENTERVILLE, MA 02632 ___ Est. Project Cost: $ 2,500.00 Chimney:
Description: siding&3 windows `Permit Fee: $35.00
Insulation:
I ' Fee Paid:,` $35.00
Project Review Req: GLAZING REPLACED IN HAZARDOUS LOCATIONS AS DEFINED
IN 780 CMR MUST BE TEMPERED OR EQUAL- '} Date: 10/15/2020 Final:
r � Plumbing/Gas
" a Rough Plumbing:
Building Official
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months'-afteejssuance. 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-Taws 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 aand 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)
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:
elk
Q...............................
Application number.,lam.
•� BUILDIN
G DEPT. Fee..................... ��..�.. .......................
MAS& OCT 1 �3 2020
Building Inspectors Initials.. ..............................
10.).1.1121.2
TOWN OF BARNSTABLE Date Issued..... .... . ............
, XX ,.
SC E® Map/Parcel.......:?�.,1.ff.:..U.�.... ..........................
�� ao WN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION
PROPERTY INFORMATION
Address of Project: 3 Rs L"q, i f9 a2 o�
NUMBER STREET VILLAGE
Owner's Owner's Name: ,,t� f � Phone Number
Email Address: Cell Phone Number
Project cost$ 2 Svo Check one 'Residential Commercial
OWNER'S AUTHORIZATION
As owner of the above property I hereby authorize
to make application fora uilding permit in accordance with 780 CMR
Owner Signature: 2 Date: /�T42 2 D
TYPE OF WORK
Siding 10 Windows(no header change)# ❑ Doors (no header change)#
❑Insulation/Weatherization ❑ Roof(not applying more than 1 layer of shingles)
❑ Commercial Doors require an inspector's review
Construction Debris will be going to
❑ Certificate of occupancy with no construction (complete below)
Occupant/family relationship or business name
or Existing amnesty apartment(attach a copy of recorded comprehensive permit)
CONTRACTOR'S INFORMATION
Contractor's name 1',(J?Pao %/iko P=U
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 75 YEARS OLD OR/F THE SUBJECT PROPERTY IS/N
A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED.
APPLICATION NUMBER
*For Tents Only*
Date Tent(s)will be erected Removed on number of tents total
Does the tent have sides? Yes No (If yes please attach floor plan with exits marked)
Dimensions of each Tent X X X
Additional tent dimensions can be attached on a separate piece of paper.
Purpose of Event `T
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 Yest,--' 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 * w
Manufacturer# Model/I.D.
f
Fuel Type Testing Lab
Offsets from combustibles: front back left side right side
HOMEOWNER'S LICENSE EXEMPTION
Homeowner's Name: 4z Z4 X `
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.
SignatureA ��.�u� Dated - 02 0
APPLICANT'S SIGNATURE
Signature Date Igo- �L_ D.2 O
A-9 4 42 Zdo 04q
All permit applications are subject to a building official's approval prior to issuance.
w`
• The Commonwealth of Massachusetts
Department of IndustrialAccidents
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)'0��tion/Individual): a6,,, M n"J
Address:
City/State p: ®ZGo Phone#: E0,Y
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 g• ❑Demolition
workingfor me I an capacity. employees and have workers'
Y P h'•
[No workers'comp.insurance comp. insurance.: 9. ❑Building addition
required] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
® officers have exercised their I I. Plumbing repairs or additions
3. I am a homeowner doing all work 0 g P •
myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs
c. 152, 1(4),and we have no _
insurance required.)t § 13.�Other
employees. [No workers'
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. _
ZContractors 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.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 cqjo under the pains andpenalties ofpedury that the information provided above is true and correct
Signal Date:.
`
Phoi��:
Official use only. Do not write in this area,to be,completed by city or town official
City or Town: Permit/License#
L
uing Authority(circle one):
oard of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
Other
ntact Person: Phone#:
Information and Instructions ;
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required"
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the 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 bum leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington.Street
Boston,MA 02111
Tel.#617-727-4900 ext 406 or 1-877-MASSAFE
Revised 4-24-07 Fax#617-727-7749
WWW.mass.gov/dia
7, •rT
`��� .�,. �r: ♦ � r� { �-� .. u... i., 'A�k :�„ �,��` .. yJy�*,r '-a� ; a„{ fl! y '��'/� ` _� ��`"'^:•y�
'.�`t�'.. . .r�*rl" ,r y . & , `p'�y.`-s,�,�1i,�✓ti+,Yt ,Y,,+� 7 fit.r r. /�F1 ��-'b
+'R"'��'.`!'�f
wr• y
:.P/w t �, w 4 ;r.. �'"l# id i i. '.a ".r na•�'m:~ P d {f�yr �'//l�"`' yi'=a�i l"i ,,.E,.K.. `I d, : .
I t ei •,
• � Y
w,-
»
t
a -..", n _ ;. -..are-._,.J,. � 'w"'+'tF' ' pZ'✓
Out#� AL��'4 � � �� y�j� w *^Xr`"r�}"'�'^ M awwMrs♦ � + �(s i1� �.
JR
F _ r
tAm
p 4 s
,.M tQlr� 71w,
,e
i..'}
J� SS
-517
AL
,
r
v
P *dr
M
Parcel Lookup Page 1 of 1
I H
07
Logged In As: Pa rce I Lookup ' Monday,April 22 2013
Road Lookup Condo Lookup Multiple Address Lookup Reports
Search Options L
Search By Owner !;
Owner Name
RIVERA
Search,
<Prev Next> Page 1 of 1 Rows/Page:F T OF
Parcel Location Owner Village Map
289-141 15 STERLING ROAD RIVERA,AIDA HY 289141
291-014 385 MITCHELL'S WAY RIVERA,AIDA G& MAURO HY 291014
291-016 458 PITCHER'S WAY RIVERA,ALPHONSO& DIANA HY 291016
252-085 943 PHINNEY'S LANE RIVERA, GEOVANY& MARIA N HY 252085
250-080 295 OLD STRAWBERRY HILL ROAD RIVERA, LUIS H HY 250080
249-018 617 STRAWBERRY HILL ROAD RIVERA, MAURO 0&AIDA CEN 249018
246-070 34 STRAWBERRY HILL ROAD RIVERA, MAURO 0&AIDA G CEN 246070
292-095 1 GENERAL PATTON DRIVE RIVERA, SUYAPA C I HY 1292095
http://issgl2/intranet/propdata/lookup.aspx 4/22/2013
oFT KKE r Town of Barnstable *Permit#
Expires 6 moniim&om'
Regulatory Services Fee �7
+ BAENSTABLE • -
MAss.9
i639. Thomas F. Geiler,Director`��
�pTED MP't 4
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis, MA 02601
www.town.bamstab le.ma.us
Office: 508-862-403 8 Fax: 5 08-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL_ ONLY
Not Vaiid without Red X-Press Imprint
Map/parcel Number
Property Address -� ZZ 5,_ - ff—ell YXIOWS
P
19 Residential Value of Work 0t;2 Minimum fee of$3.5.00 for work under$6000.00
Owner's Name&Address Gt1L Z964
Contractor's Name �{/a �/�0,10 (lOL/Pr Telephone Number iepj Q 72 = 2 5
Home Improvement Contractor License#,(if applicable)
Construction Supervisor's License.#(if applicable)
❑Workman's Compensation Insurance
Check one: rl �
❑ I am a sole proprietor i -
1 am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ ,Re-roof(stripping old shingles) All construction debris will be taken to '
❑ Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
#of doors
Pr Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows
*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
�c'�
required.
Az-!C�
SIGNATURE: �
i
Q:\WPFILES\FORMS\building_permit forms\EXPRESS.doc
Revised 070110
The CommonweaUklofMassachusetft
Depaphnent o,Industrial A cciden&
Orke of Invesfigadow
600 Washmgton Street
Boston,MA,02111
nnwv.mass.gvv1dia
Workers' Com-pensation Insurance "Affidavit. Buiders/Contractors/Electi cians/Plumbers
.Applicant Information Please Punt Legibi
Na=MusinewAkpn on1idividnai):
Address:� �%frt« _ fi� lo
City/State/Zip: PhhEme#: . e 2 2- 2 57
Are you an employer?heck the appropriate box: Type of projectrerlaii-e :
1.0 I am a employer with 4. ❑ I ate a general contracou and I
�p
to full and/or * !rave bind the sorb-ovntzactcars 6. ❑New construction
part-time)-
Z_❑ I am a sale pmpaietor orpartner lasted an the attached sheet 7. ❑Remodeling
ship mid have no employees These sub-contractors have $. ❑I)em,olition
wodcing forme in any capacity_ employees and have woda!rs'
[No wodmrs'comp.insurance comp.msarancr I 9. ❑Building addition
mod] 5. ❑ We are a corporation.and its 10.❑Electrical repairs or additions
a�cers have eiercised their 3.� I am a homeovetner doing all work 11_❑Plumbing repairs or additions
Myself [No wcukm'cones- right of exemption per bIGL 12.❑Rs of repairs
insurance required.]T . c. 152, §1(4),and.we have no /
employees.[No war300ess' 13.0 D#her��/OL�P� lN�
comp.insurance requiter!.],
!Any apphcmrt that checks box#Lmnst also 5ll a=the section below showing their workers'compensatiam police infvtmatian-
I Home meets who submit this affidavit indicating they are doing au wed and then bra oafs&contracmrs mast submit a new affidsM indicating sack
ICantractars that check this biz mint attached as additional sbm showing the name of the sub-c=nacurss and state whether ar not those entitkis yzve
employees. Ifthe mb-sontmctors have ewp1oyee0heytmut-provide their workers'comp.policy auvaber
I am an employer that is ptavvi&ng workers'comperts Wan&=rmce for my ezrploy Belotv is thepoHey anud,job sits
informad'os.
1==xe Company Nam:
Policy; or Self-ins-Lic.47 Expiration Date:
Job Site Address: City/Stateizip:
Abach 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 tc the imposition of criminal penalties of a
fine up to S L500-00 and/or one-year impcispnment,as well as civil penalties in the form of a STOP WORK,ORDER and a tine
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 tLe DIA for mm asnce co-omm9e verification
I do herebj,ce '00 ndar the cud penaWes ofpedary that the:informaliva provided aboue is bw and carrel t
Si P Date: ozz
Phone At:
Offiddl trss Only. Dv nOi writs in this area,to be cautplatad by city or ttvwrl o fi'ciaC
Cit
5'or Town: PeradbUcense#
Issuing Authority(circle one):
1.Board:of Hralth ?.Budding Department 3.City/rown Clerk 4.Electrical Inspector S.Numbing Inspector
6.Other
Contact Person: Phone 9-
6
r Town of Barnstable
Regulatory Services
1ARNSTA13LE Thomas F.Geiler,Director
9 MASS` $
�p 039• p.� Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: ,y
JOB LOCATION: p �j //1 Lh e 4,6s Ll / L1 YAIIIA/f s 111
number street village
"HOMEOWNER": /?;62,Qo 2V 2
name home phone# work phone#
CURRENT MAILING ADDRESS: Crp C cr cc�:l3'plp�d && 4!6
city/town 0e, state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to
be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner.' Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be
responsible for all such work.performed under the building permit. (Section 109.1.1)
i T
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
.The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
require ents.
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to complyywith the
State Building Code Section 127.0 Construction Control. .
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q
Rules&Regulations for Licensing.Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require;as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and.adopt such a form/certification for use in your community.
Q:forms:homeexempt
IHEr Town of Barnstable -
. �. Regulatory Services
• HAMSTasL&
y Mass. Thomas F.Geiler,Director
�p 1639• ��
rfn Nw�°r Building Division
Tom Perry,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 Us ing A Builder
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
kae e:;, Z--�
Signature of Owner Date
Print Name
If Property Owner is applying for permit please complete the
Homeowners License Exemption Form on the reverse side.
Q:FORMS:O WNERPERMISSION