Loading...
HomeMy WebLinkAbout0064 MURRAY WAY M Town of Barnstable Building „Post This Card,So,That,�t is Visible;-From the Street Approved Plans Must beRetamed on3Job and this Card Must°beKept * MkRN5T[ABL6, 3+ ' .- < X' .•, x - ,,,. �3 s{ £ i:. 3 `z Permit M" Posted Until,Final Inspection Has Been Made - ' � 3 Eor Where a Cerfiifcate..of0�ccu,pancy rsRequred,such Buildn gshall Not be.Occupoeduntol a Fina!inspectvon has been made G Permit No. rn B-20-860 Applicant Name: BOLIVAR E IDROVO Approvals Date Issued: 03/18/2020 Current Use: Structure Permit Type: Building-Sheet Metal-Residential Expiration Date: 09/18/2020 Foundation: Location: 64 MURRAY WAY, HYANNIS Map/Lot: 307 245 Zoning District: RB Sheathing: ' N Owner on Record: SILVA,JHONATAN SOUZA g Contractor Name BOLIVAR E IDROVO Framing: 1 Address: 29 RACWCLLE COURT Ifa � ' ConfractofiLicense: 7623 2 MASHPEE,MA 02649 =, "a Est Project Cost: $ 11,000.00 Chimney: Description: INSTALLING DUCTWORK FIRST AND SECOND FIOOR,REL®CATING $85.00 � EXISTING OUTLETS ON FIRST FLOOR AND ADDING UP-RETURNS ON Insulation: Fee Paid: $85.00 SECOND FLOOR BEDROOMS '• Final: Date ` 3/18/2020 Project Review Req: �� � X N 3 � - t �� 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`ttiis 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,o�oadPand shall be maintained open for public inspect on 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. Service: Minimum of Five Call Inspections Required for All Construction Work: P q �. e 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest 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: i 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 e Commonweal@ of Massachusetts Shee&' et-#1 PQmit Date: 03 - Permit# Estimated Job Cost: $ %/.4W• s1 ti Permit Fee: $ Plans Submitted: YES NO '� Plans Reviewed: YES NO Business License# G 23 Applicant License# Business Information: Property Owner/Job Location Information: Name: O/iJAY 1�rOV 0 Name: A�1 �Jai 0 g Street: 993 Street: ��C� ier� SCANNED City/Town: City/Town.: "'10S MAR 1'8 ZOO Telephone: ` 1 if Z 91/ 2 Telephone; 4 2 e'8 4D 17 Photo I.D.required/Copy of Photo I.D. attached:" YES NO Staff Initial stricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq.ft /2-stories or less Residential: 1-2 family, ✓ Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial " Educational ' Institutional Other Square Footage: under 10,006 sq. ft. 4-0"' over-10,000 sq.ft. Number of Stories:: Sheet metal work to be completed: New Work: Renovation: y HVAC v, Metal Watershed Roofing Kitchen Exhaust System `Y. Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: 5' 11 d9 Yt8`Y co rr) l Town of Barnstable Regulatory.Services RA&NGrABLF' Thomas F.Geiler,Director was 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 Using A Builder I, 77�0AAjA41 S~�JLW ,as Owner of the subject property hereby authorize 6.0 Iva 1(_ ` l /'0 V-0" to act on my behalf, in all matters relative to work authorized by this building permit. (Address of Job) *Pool fences and alarms are the responsibility of the applicant. pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. ignature of Owner Signature of Applicant. <v S 04 Print Name ' Print Name ate Q:FORMS:OWNERPERMISSIONPOOLS 1 b�• i f k.—.- �.l' �_ 1:' _ GDD I•f7619�18R IB�I Iv0 MGM WF, ►LTHQFM � ►�HIS�'r�' k SHEET METAL WORKERS I i ISSUES THE FOLWWING'LIDENSE { 7 1S'P R UNREST y„ "OUIUAR F $0013EARS�S ViV..RAPT 655 HYANNIS,MA`02601 S08219 ,, g 7623 t�'T12812Q�� a . w1 4r INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch..112 Yes dNo 0 If you have checked Xes,indicate the type of coverage by checking the appropriate box below:.. A liability insurance policy Other type of indemnity ❑ Bond OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent E] Signature of Owner or Owner's Agent By*hooking this box ,I hereby eertify that all of the details and information I have submitted(or entered)regarding this applioation am true and ` aoourate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be In oomplianoe with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection.required prior to insulation installation:YES -NO Prosress Inspections Date Comments ( r Final InsAection Date Comments Type of License: By 9 Master , Title ❑Master-Restricted Citylrown [,Journeypersori Signature of Licensee . Permit# ElJourneyperson-Restricted2� • License Number: Fee.$ Check at Inspeotor Signature of Permit Approval The Commonwealth of Massachusetts ' Department of Industrial Accidents Office of Investigations 600.Washington,Street Boston,MA 02111 www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/.11lectricians/Plumbers Applicant Wormation Please Print Le 'bl Name(Business/organiz on/ludividual):. 06(/ t;lrajo Address: 3 City/State/Zip: CM Art) Phone.#: Are you an employer?Check the appropriate bog: Type of project(required): 1.❑ I am a e to er with -4. ❑ 1 am a general contractor and I y have hired the sub-contractors' 6. ❑New construction . -employees(full and/or part-time). . 2. 1 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 1 [No workers' comp.insurance comp.insurance.+" required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roofrepairs 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. lConactors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have emp:oyees,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.# 02 5- M 1155-13 Expiration Date: ./0-OS- Z 0 go Job Site Address: d -G6 a)&q City/State/Zip: A-q 0V3 ,/YQ OZ(,°©/ 4 CA Attach a copy of the workers'compeilYation 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$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under t nand penalties of perjury that the information provided above is true and correct Sizaafore: t Date: Phone Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# .Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: "* Town of Barnstable Building r _ ; Post This Card So That�t�is�Vis�ble Fromethe Street Approved Plans�Mustbe:eReta�ned on Job and this Card Must be Kept ,�` ABI �$ Po'sted Until F nal Inspection Has'Beeri Made k � ' a 3 Permit ea�+s Where a Certificate�o�f Occup icy is Req fired,such Buldmg shoal) Not be Occupied�unta F�nal¢Inspec�tio�n has'bee�n made Permit No. B-20-352 Applicant Name: CHRISTOPHER CTRIPP Approvals Date Issued: 02/27/2020 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 08/27/2020 . Foundation: Location: 64 MURRAY WAY,HYANNIS Map/Lot: 307 245 Zoning District: RB Sheathing:. Owner on Record: SILVA,JHONATAN SOUZA Contractor Marne CHRISTOPHER C TRIPP Framing: 1 Contractor License. CS 112862 Address: 29 RACHELLE COURT { 2 MASHPEE, MA 02649 k6 ' Est Project Cost: $250,000.00 Chimney: Description: New Roof New Windows Doors New Plumbing Electrical HVAC and P6(k it Fee: $ 1,325.00 Kitchen and Flooring. Repair framing where fire was >Smokes.and = Insulation: Co Dectectors. Baths. ' a Fee Paid $ 1,325.00 ' kwDate 2/27/2020 Finals Project Review Req: �; � x a �crn IZ 9— Plumbing/Gas Rough Plumbing: A .Building Official E> Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized;by this permit is commenced within six mo the afterissuance. All work authorized by this permit shall conform to the approved application and theapproved construction documents`for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and str'i' res shall be m 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 i ' 'ion for the entire duration of the Final Gas: �. work until the completion of the same. Electrical ffi The Certificate of Occupancy will not be issued until all applicable signa&tur s by the Bu�ldmg and Fire- ff cialslare otovi ed on this permit. Minimum of Five Call Inspections Required for All Construction Work { Service: 1.Foundation or Footing 2.Sheathing Inspection µ _ � x x Rough: 3.All Fireplaces must be inspected at the-throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: ! r �tNE gU�LDMC, — ll Application Number...... �d. , B 0 5 2024 RAx M.433r.>E, : FE MAsa TAg�E Permit Fee. .Other Fee: 163 w ()F BARNS Total Fee Paid................ ... ...... TOWN OF BARNSTABLE Permit Approval by... .........:....on.. ... .. .. BUILDING PERMIT --� .. '�.D. ...........Parcel..:. l� Map....... (.. .... . .................. APPLICATION / Section 1 — Owner's Information and Project Location - Project Address Village Owners Name .�l!-1,(, SCANNED ti � g Z q � 5L GC— C r FEB 17 2020 Owners Legal Address_ City. /� l� �!' - State /J . Zip O Owners Cell#Y7 7 _Z KQ�'/0/q E-mail �' /� Fell 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 ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty [ Fire Alarm Rebuild ❑ Deck _ Apartment © Sprinkler System ❑ Addition ❑ Retaining wall ❑ . Solar Renovation ❑ Pool Insulation Other—Specify Section 4 - Work Description 0, � f /Q I1_r U ILA s 6 _1-v elo Tact undated- 11 Ii in 11 R {r t 1 Application Number.....................:.............................. Section 5—Detail Cost of Proposed Construction 00 0 Square Footage of Project :20190 /rvy Age of Structure %?ZZ Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) l� 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ( Wiring 11 ❑ Oil Tank Storage . Smoke Detectors { / ✓{;, (� Plumbingt, it P] Gas ❑ Fire Suppression F ❑ Heating System El Masonry Chimney Add/relocate bedroom i Water Supply Public ❑ Private A , Sewage Disposal Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway c Debris Disposal Facility: --ji(/ e !�� am using a crane ❑ Yes �No -=� Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Proposed Side Yard Required Pro r Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 3 Application Number........................................... Section 9- Construction Supervisor Name J fa C. TTelephone Number Address G, X,X .;ne ���.. City `'("' State- Zip d� License Number C5-jd2SCo,�, License Type C-5 Expiration Date Contractors Email ��'i�,pcd.�Ce s -.f�l 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 orvn-of Barnstable.Attach a copy of your license. Signature Date a- X410gd Section 10-Home Improvement Contractor Name_ CGtd'i 61on ky— C' Tr, in Telephone Number Address �yr,44( )e- fi City co f u t, State Zip aa6 fi Registration Number [ _Expiration Date z 2- C—Y& I 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 CW and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date �Sl. oG Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date h/-77 Print Name 'on Telephone Number y j(Jl E E-mail permit to: N' fiwaG� Last updated: 11/15/2018 Section 12—Department Sign-Offs . Health Department ❑ Zoning Board(if required) ❑ 1 Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation I For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization S Sly I, � � ✓ , as Owner of the subject property hereby authorize ' l/— `��/Z,�-tl (�(/,( ,Lt� -,,.,Ito act on my behalf;in all ; matters relative to work authorized by this building permit application for: (Address of job) ®2 0 ignature of Owner date Print Name ^MF Last updated: 11/152018 z- Comfnonw,ealth..of Massachusetts y Division of Professional Licensure Board of`Building Regulations and Standards . Constyrtpg4S' rvisor' IP CS-112862 -�iy' �, �pires:12/2W2022 � i '� r �. CHRISTOPHA-C 12 GERALDIN� 0l1 COTUIT MA 0z65��;'� Commissioner Office of Consumer Affairs&Business Regulation HOME IMPRO EMENT CONTRACTOR TE:Individual Registration valid for individual use only { Ft before before the expiration date. If found return to: eai Ex ir 'Office of Consumer Affairs and Business Regulation 07/30/2021 1000 Washington Street -Suite 710 CHRISTOPHl=14j -� � " � � Boston,MA 0211a - iV CHRISTOPHER 12 GERALDINE RD`•k v COTUIT,MA 02635 �a Undersecretary Not valid without signature • Town of Barnstable Building Department Services II.W..�, ,� Brian Florence,CBO i6l �`� Building Commissioner 200 Main Street,Hyannis,-MA 02601 www.town.barnstable.ma.ns Office: 509-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section - If Using A-Builder as Owner of the subject property hereby authorize C�rl5inhfoz C riven to act on my behalf in all matters relative to work authorized by this_building permit application for. O'��O/ (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized beforefence'is installed and all final ins e e performed and accepted. Si - tune of Owner of Applicant Print,Name Print Name OJ 2020 to QTORM&OWNERPERMISSIONPOOLS Rev:09/16/17 Town of Barnstable Building Department Services Brian Florence,CBO ' Building Commissioner • 200 Main Street, Hyannis,MA 02601 >t+► www.town.barnstable.ma.us Office: 509-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXUdP nON flem Print DATE: a JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAU.NXG ADDRESS' atY state zip code The current exemption for eowners" extended to include gnMgMied dv ellin of six units or less and to allow homeowners to engage an indivr f hire who does not possess a license,govided that the owner acts as supervisor. DEFMMON OF HOMEOWNER Person(s)who owns a parcel of 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 structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period no be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Burn ' Official, he/she sha_,lobe responsible for all such work performed under the budding permit. (Section P 109.1.1) The undersign omeowner" s responsibility for compliance with the State Building Code and other applicable codes, bylaws,rule and regulations. The undersigned"homeowner"certifi that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that e/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings ntaining 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. '�'• HOMEOWNER'S EXEMPTION The Code states that: "Any; omeowner 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 2.1 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 helshe understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q MPFIL.FSIFORMSWuilding permit forms\EXPRESS.doc 08/16/17 The Commonwealth ofMassachusetis Department of IndustrWAccidents Office of Invest1gations 600 Washington Street Boston,MA 02111 www.mass govItUa Workers' Compensation Insurance Affidavit: Bw7ders/Contractors/Electricians/Plumbers Applicant Information ? 1 Please Print Legibly Name(Business/Organizatimvindividual): F,�V4� l�YlO/ pj i� Address: : ���✓ d-�'y1�. �, City/State/Zip: 0 l , Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with- 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.E] I am a sole proprietor or partner- listed on the attached sheet. 7. ERemodeling 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.insuuance . comp.insruran0e,t , required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside 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. r lam an employer that is providfng 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:A b4,t'4- 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 ' ar alties-ofperjury�ilia hififin ion provided above is true and correct Signature Date: 2 Phone#: Official use only. Do not write in this area,to be completed by city or,town oftial 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 M 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 insnranceIcoverage 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." 4r 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 numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would 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 Investipt ions 600 Washington Street Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAM Revised 4-24-07 Fax#617-727-7749 www.mam.gov/dia , . � Town of Barnstable . i ig A Post This Card So That it is Uisible;From the Street App"roved Plans Must be Retained on Job and this Card Must be Kept �/ M'� Posted Until Final Inspect�on<HaspBeen Matle s �� �� Rx s ,w ..,;;. z rx'x�2&t ' s �$. a, act; v✓ a :a. s Jsrmit b °1Where a Certificate of Occupancy Required,such Build ngshall Notbe Occupied unta P IInspection:hasbeen mad,eA Permit NO. B-20-248 Applicant Name: HOMEOWNER IS APPLICANT Approvals Date Issued: 02/04/2020 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 08/04/2020 Foundation: Location: 64 MURRAY WAY, HYANNIS Map/Lot: 307-245 Zoning District: RB Sheathing: Owner on Record: SILVA,JHONATAN SOUZA Contractor Name:' HOMEOWNER IS APPLICANT Framing: 1 Address: 29 RACHELLE COURT Contractor License: EXEMPT 2 MASHPEE, MA 02649 p Est Project Cost: $ 10,000.00 Chimney: Description: Gut the house inside house 1st`floor and 2nd floor windows and Permit Fee: $ 101.00 roof and siding.This is a Duplex 65-66. Demo Exploratorotry Fire. Gµ Insulation`. Fee Paid. S 101.00 Project Review Req: • Date s 2/4/2020 Final Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work a honied'by Ifficial this'permit is commenced within six months after issuan Final Plumbing: All work authorized by this permit shall conform to the approved application"and the approved construction documents-for which-tthis permit has been granted. All construction,alterations and changes of use of any building and structures:shall be incompliance with the local zoning by laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road a d shall be maintained open for public mspeetion for the entire duration of the work until the completion of the same. Final Gas: 'g 2 e� The Certificate of Occupancy will not be issued until all applicable signatures byvahe Building and,Fire Officals are:proyided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 4 1.Foundation or Footing 2.Sheathing Inspection . 3.All Fireplaces must be inspected at the throat level before firest flue,lininiLi 'installed A a „ ,,;; Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Final: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: 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: IKE C:7 ApplicationNumb.,..z............................ BUILDING 101- ................... • BAWMABIX KAS& Permit Fee................... ..Other ..................... Total Fee Paid........ .......................................... ...... U TOWN OF BARNSTABLE Permit Approval by.. ............on. BUILDING PERMIT Map..................... .. .............P&Mel.... .................. APPLICATION SCANNED Section I — Owner's Information and Project Location FEB 3 202 Project Address-a/,�—/—a Az 9x&k Village Owners Name Owners Legal Address. z A ig� City lk�1,cl C� State zip .41 Owners Cell #,,�7�2az "0 E-mail 0 04"t" Us FSection 2 —Use of Structure Use Group x:�2� 0 Commercial Structure over 35,000 cubic feet Commercial Structure under 3 5,000 cubic feet Single/Two Family Dwelling Section 3 — Type of Permit ❑ New Construction F Move/Relocate E] Accessory Structure F-1, Change of use El Demo/(entire structure) ❑ Finish Basement El Family/Amnesty El Fire Alarm Rebuild ❑ Deck Apartment Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar El Renovation ❑ Pool 0 Insulation Other—Specify nie, Section 4 - Work Description zM Last undated: 11/15/2018 Application Number.......... Section 5—Detail , Cost of Proposed Construction Square Footage of Project Age of Structure Dig Safe Number ;4 # Of Bedrooms Existing y Total#Of Bedrooms(proposed) F f 110 MPH Wind Zone Compliance Method MA Checklist ❑ WFCM Checklist ❑ Design Section 6 Project Specifics ❑ Wiring Oil Tank Storage A "'� Smoke Detectors i ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney '' "�' ' El 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 IiNo i Section 7—Flood Zone Flood Zone Designation r I. Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) e Setbacks Front Yard Required Proposed . Rear Yard ,Required r Propo'sed ` Side Yard Required Proposed a Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 c ; ,f 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 ` Date Section 10—Home Improvement Contractor Name 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: Z 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 Massach etts State g Code. I understand the construction inspection procedures,specific inspections and documentation ed b 80 and the Town of Barnstable. Signa Date APPLI T SIGNATURE Signature Date Print Name �� �� i¢/L , 1,1X Telephone Numbe 2� E-mail permit to: h p,,�A ,¢ti - jjs,¢r�o)�ij 0 f/�I,¢,�L Last undated: 11/15/201 R Section 12 —Department Sign-Offs , Health Department ❑ Zoning Board(if required) ❑ _ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation i For commercial work,please take your plans directly to the fire department for approvak Section 13.—Owner's Authorization as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) , Signature of Owner date Print Name . t � r � Last updated:11/15/2018 The Commonwealth ofMassachusetfs Department of Industrial Accidents Office of Investigations IF 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractois/Electricians/Plun hers Applicant Information Please Print Leptibly Name(Business/Organimtion/Individuely iv Address: — City/State/Zip: o2'4'1Zne#: 7 41//-,7�g /0 z 2 Are you an employer?Check the appropriate box: Type of •ro'ect 4. I am a metal contractor and I .P ] (�lm�• L❑ I aim a employer with- ..❑ g 6. lew construction employees(full and/or part-time)." have hired the sub-contractors 2.[:] 1 am a sole proprietor or partner- listed on the artached sheet. 7. ❑Remodeling ship and have no employees These ors have 8. Demolition working for me in employees and have workers' �Y capacity., 9. Building addition.. [No workers'comp.insurance comp•11131671Msnce•2 raluired.] I ;S. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11.E Plumbing repairs or.additions myself:[No workers'comp. r. right of exemption per MGL 1211 Roof repairs insurance reTlhv&l t c.152,§1(4),and we have no o employees.[No workers' 13.❑Other comp.instance required-] ;Any applicant that checks box#1 most also IM out the section below showing their workers'compensation policy infonaetion. t Homeowners who submit this affidavit indicating they are doing all work and then hie outside conractors must submit a new affidavit indicating such. $Contractors that check this box mustattached an additional sheet showing the name of the sub-contractors and state wbethm or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy mmnber. ' I am an employer that is providing orhers'compensation insurance for my employees. Below h the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: �"F'�(7 �}'�~l/Vi�� City/State/Zip:Z /�/ � Attach a co of the workers'compensation policy declaration page(showing the policy number and expiration date). PY P P cY P g ( g Po'cy zp' ) 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 ce rtify nder sins d es o 'u1'that the information provided above is true and correct Si Date: Phone#• QJjwkd use only. Do not write in this area,to be completed by city or town oakial 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 wpkyee is defined as"...every person hi 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 is 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 therem,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair wank 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 contrad 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),add=(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 eater 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 m 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 blue 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 Dgwtment of Industrial Accidents Office of Investigates 660 Washington Street BoAan,MA 02111 Tel.#617-727-49M ext 406 or 1-877 MASSAFE Revised.424-07 Fax#617 727-7749 Www.mass.pv/dia } _ III ,4 5tr�ir✓ SMOKE DETECTORS REVIEV%PECl BARNS TABLE BUILDING OEPT. _ FIRE ENT D47E BOTH SIGNATU ES ARE REQUIRED f0R PERMITTING I yy- ' egg K�tcI�EN �� KtG�,E�. RK _ L®��G i0l ( xi/—( WA FE p 5 202 �.�2 yy h Y4 n!NI —^ . TpVVN pF BR��S _ Er�A?rHI - SCANNED stA� �P IAA,;. FEBq '( q INS CD 1 1 �LD �/ +0 I f 0". rob G 4 3,0 a \ 61 NOSE 00(jaL6 (-o 46, ! WALL fo WILD \3AS6MCly i ALL f I,C(,✓A\� vP 0 tI C- 60fif0n- SIOF j Spv f h I,� f t 1 f , 117 --- - Gam— mo — 101 -s C ( ! 60 � y, E Q ( 0041 �--�' ( 6�66 �Gi/��sl•r fvAr 6Y$ �I.---. 6X� �' Ar/4,;v)S-M q o26'o/ ao5�t � V - yawl [joy ii row o _ N �61-7 M E 100AA ® i �OE JMo�E _ E t .» - val —___f- 2tiD FC•ooQ PlgN�xls�f.� fo �� • Q�M�1�N�N� t 7 I 1 t - � 7 � 11 ' 4 2 /lot/ AltO IDOO S ,� Sn�oxb M�K�i a G�p ,