Loading...
HomeMy WebLinkAbout0018 OLD FISH HILLS ROAD Application number v ®.. /® Fee............. ............................................................... MAS&' -SCANNED Inspectors Initials....�.�......................... 3 Date Issued........ y...b...?- .............. ....................... Map/Parcel... .. ......(. ............................ TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: ) 9 01 � 6L771 )% n S 'NUMBER STREET 2LAGE Owner's Name: ��» � ' Phone Numb _ � G Email Address: (�y ; "GigC`�W Phone Number 101� ??k Project cost$ �� +�`J - Check one Re dential E Commercial OWNER'S AUTHO TION As owner of the above property y I hereby authorize t - � t , r to make application for a building permit in accordance with 780 CMR Owner Signature: Date: (2,o TYPE OF WORK Siding Windows(no header change)# Z Q Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review 0 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to S 40 C D CONTRACTOR'S INFORMATION Contractor's name LOP t S r�81 i s Home Improvement Contractors Registration(if applicable)# l 1 �{ (a T (attach copy) Construction Supervisor's License# D 15> 2 00 (attach copy) Email of Contractor �L-C J _ COA 14,<�. n 4hone numd 5a T, '?7 6. —0 51 ALL PROPERTIES THAT HAVE ST CTURES OVER 75 YEARS OLD OR/F THE SUBJECT PROPERTY IS IN 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 (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a$epar iece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with location(s) of each tent If food is being served at your event please obtain a Health Department approval be en the hours of 8:00am -9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. . Fuel Type �TeLab Offsets from co bustibles: front back :::��efftte right side HO WNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regu tions for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts . to Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature 11L SLDate !Q All permit applications are subject to a building official's approval prior to issuance. 1 He uommonweatin of massacnusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /J Please Print Le 'bl Name (Business/Organization/Individual): to C)3 S ('�- i S Address: City/State/Zip: Phone#: !&4� � Are you an employer?Check the ap ropriate 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 IDI 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' comp.insurance. 9 Building addition [No workers' comp.insurance P• required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. 1 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 -5tJ 0-44 kd-Vu_ 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. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under pains and penalt',s of perjury that the information provided abo is ue and correct. Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town ofciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Commonwealth of Massachusetts ® Division of Professional Licensure Board of Building Regulations and Standards Construction,,,$`uWVji$br,,1 & 2 Family CSFA-057006 pires: 02/26/2021 LOUIS A STERGIS. f � _ 8 STONEFIELD DRNE i > EAST SANDWICH MA 02537' ' Commissioner ✓� C�i�ni�zo2�cn¢�l�n��aYJo,�uJelG: Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registration,' Expiration ' rt — 09/19/2021 LOUIS A STER(ISN� _ !y D/B/A THE STERGfS GOIu�eAISIY; N LOUIS A.STERGIS� 8 STONEFIELD DFi rn.dCL "aGf�smk" E SANDWICH,MA 02537' Undersecretary Application numb ............................— Fee ....................................................... WAS& Building Inspectors Initials.... r7y....................... AUG 22 2P18 Date Issued.............a ..............................................i -RAN % 8ARR1,S^(AB1 F - Map/Parcel....J 95 pp ......................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDINGNvqNDOWS/DOORS/TENTS/STOVESAVEATHERIZATION PROPERTY INFORMATION Address of Project: j� 0% �15 �/� /LCOQa� / c,r/�'S NUMBER STREET VILLAGE Owner's Name: ::56k,.J Q, Phone Number Email Address: Cell Phone Number Project cost$ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building pen-nit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK F-1 Siding Windows (no header change) # InsulationiWeatherization. Doors (no header change)# Commercial Doors require an inspector's review PRoof(not applying more than I layer of shingles) Construction Debris will be going to vI4- -7-A-"A r-3. CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)#ZIA�Z-".7 (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor J werbf Phone number 51e ALL PROPERTIES THAT HAVE STRUCTURES OV R 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. r APPLICATION NUMBER ............................................................ *For Tents Only* a Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location (s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am -9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval ,*WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: 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'S SIGNATURE Signature Date All permit applicat ions are subject to a building official's approval prior to issuance. .. ' rTTH HOME IMPROVEMENTS 4 PH. 508.328.1635 4 v Exterior Remodeling Experts BBB, M Web: www.thomashomeimprovements.net Fully Licensed & Insured P.O. Box 177 Construction Supervisor Lic.#99913 Centerville, MA 02632 THOMAS HOME IMPROVEMENTS LLC. PROPOSES TO PERFORM THE FOLLOWING WORK: Location of proposed work: Mr. & Mrs. Duffett 18 Old Fish Hill Road Hyannis, MA 02601 Date on which construction should begin: July 2018 The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be avoided by the contractor shall not be considered as a violation of this contract. The contractor agrees that when such delays become known to the contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which must be repaired, creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the duration of the work and the schedule date of completion may differ,and that such variation is not to be considered a violation of this contract. Cost for labor and materials under this contract: $9,430.00 30 yr.GAF/Elk Timberline HD Architectural shingle(Life Time Limited Warranty) Proposal to does not include side breezeway roof. Roof to match breezeway color In the event that while stripping the roof we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$55.00 for a carpenter and$35.00 for a carpenter's laborer, plus the cost of materials. r Thank You for Giving Us the Opportunity to Help You Improve Your Project -Roof to be stripped and cleaned of all old shingles and debris -Roof to be papered with weather watch leak barrier,Synthetic roof underlayment,and installed with Timberline architectural shingles using galvanized nails. (Storm nailed) -8" drip edge& new pipe collars to be installed -Cobra ridge vent to be installed on all ridges -Timbertex premium ridge cap to be installed -A 10 yard dump trailer will be needed on site; and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED BY LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start; and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5% per month. The contractor warranties the workmanship completed under this contract for a period of ten years from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse, and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the discretion of the contractor. The homeowner acknowledges that the form, content, and notices contained in this contract are intended to comply with the applicable portions of the Mass. General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance,only such portion shall be invalid and the remainder of this contract shall be in full force effect. in addition, any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a sealed instrument on this date: Date: Homeowner Contractor The Commonwealth of Massachusetts ' Department of Industrial Accidents r Office of Invesdgations 4. 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): M-AJ / eLt- C �f Address: Pa' City/State/Zip: U1lk Phone#: Z)t9 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 6 4. I am a general contractor and 1 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.&-1Remodeling 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 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. XContractors 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: r ry p✓ 4 Policy#or Self-ins.Lic.#:a , 0/ lAdefts7i Expiration Date: —doll, Job Site Address:_ - -_ �, __...., a../� Is: City/State/Zip. Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is tr-uy e and correct. Si afore: -® Date: � `Cle®s Phone# Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACORD CERTIFICATE OF LIABILITY INSURANCE D'05��°'�Y, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED,the poticy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CNAM A Donna Ostrowski Mark Sylvia Insurance Agency,LLC PHONE 404 Main Street ��;(508)957-2125 Fax o: 50$95?-27$t Centerville,MA 02632 E.raatl :ma!kAmarksyiviainsuranw,com INSURE S AFFORDING COVERAGE NAICO INSURER A:Farm Family Casualty insurance INSURED INSURER B' _ - _ -___.._.�•7 Thomas Home Improvements LLC INSURER C PO BOX 177 Centerville,MA 02632 INSURER D INSURER E INSURER F*. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ _ r ITRR TYPE OF INSURANCE A L BR POLICY NUMBER PMMMOY EFP 1 MPM1 ICY EXP LIMITS A I X COMh9ERCIRLGEIdERAL1dABILITY 120OIXI416 5J0112018 5/01/2019 ,EACH OCCURRENCE s i,000,000 ! Te L CLAIMS-MADE is 1001000 i X I OCCUR P MIS a } I MED EXP(An one +S �D PERSONAL 8 ADV INJURY i S 1,0w,cloo G—E-,N L AGGREGATE LIMIT APPLIES PER. i}t GENERAL AGGREGATE i S 2,000,000 N POLICY 17 JEGT LOC ' PRODUCTS•COMPIOP AGG $ 2.D00;000 5 OTHER: AUTOMOSILELIABILITY C a e 1 n I LE L g ANY AUTO I t BODILY INJURY(Par parson] 3 OWNED BODILY i BODILY INJURY(Per acaa{entl S AUTOS ONLY I I AUTO5 I ROPERTY AMAGE HIRED NON•01IMED r 1 ` AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE j I AGGREGATE _ S t I DED RETENTION S S A yUORKERSCOMPENSATION 2001W8053 5/d1/ZO7� 5t0912019 S T T ERH AND EMPLOYERS'LIABILITY I Y 1 N � E.L.EACH ACCIDENT I .U�>DOO ANYPROPR?ETORIPARTNERIEXECUTIVI '' '� OFFICF.RIMEMBEREXCLUOEA? � NIA E.L.DISEASE-EAEMPLOYEE]3(S �1,ODII,OOO (Mandatory in NMI If ee descrheunder E.L.DISEASE•POLICY LIMIT I S 1,000,000 i D SCRIPTION OF OPERATIONS W. I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,-may be attachsd it more apace Is Mquiredl Carpentry Insurance coverage Is limited to the terms,conditions,exclusions,other(imitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE.ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Troy Thomas ACCORDANCE WITH THE POLICY PROVISIONS. 499 Nottingham Drive Centerville,MA 02632 AUTHORIZED REPRESENTATIVE ®19$8=2p15 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD r t, Commonwealth of Massachusetts Di+vision of Professional Licensure ' Board of Building Regulations and Standards ConstructiFn-Ss V or Specialty .._ EX plres 04/13/2020 CSSL-099913 TROY'ATHOMASa x ? 499 NOTTIN614AM A "� CENTERVILLE Ml1 Commissioner �P�m�nnit�ta+eall�a�'n��a.�aarliulellt Office of consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE-.,.00=ratl0n before the expiration date. If found return to: RRgglstra#lbn' Expiration Office of Consumer Affairs and Business Regulation t ga422 06/08/2020 One Ashburton Place-Suite 1301 TROY THOMAS HOME 1MP€I MENTS,INC. Boston,MA 62108 TROY THOMASCG -`^ 499 NOTTINGHAM QR;,: T , Not 1 d without signature CENTERVILLE,MA 02632- Undersecretary 1 Assessor's map and lot number ....... ......./ ...:.... ,_ d �FTNET� 01 769 1�J�M •� o �` Sewage Permit number .......................�,s <. � / d / / Z BAH39TdDLE, i MAl6 j- House number ............:.............................:......................:...... 90 rY�r p 039. `00� ra MPY tr' TOWN :OF BARNSTABLE C v" cst,., BUILDI-N:G ; NSPECTOR < s �- APPLICATION.FOR PERMIT TO . TYPE OF CONSTRUCTION ........................ ............ .................. .................................... . /b....��......�....................19 S y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................t 1 ��(-� .,�.�......L..,......... .. ...........:.......:......................................................... . . `. . ,. ProposedUse .................. ... . M .............................................................. Zoning-District .. .................................. ......Fire District ...,r'{.L.f.q.e. .....ZX..... !.............. . ... Name of Owner 1J.�r?.�..t.� a. ..4�":....... .1AAdd�ess .` �. . .p ..t.7n�.��..!. .. .�? 1 fi��! .�^/ -. a•v�D7� Name of Builder ..r....... ......................... ......................Address .5 ........L. ........ �i . Name of Architect .1 J............ c�. .�,r�,. ............Address ..... .�f�. ..C..�K.. f?`..... , ..................... Number of Rooms ..................................................................Foundation .........`. T..-.................................. /L� .!p. ................................................Roofing .......... ..��. : .�;. �:........ '�.1.t').....1 .. Exterior :................... f 1.2n Floors ......: ....... :� .. . .............................. n- r d Heating 4....................................Plumbing ....... . ../.. ^........................................................ ...Approximate. Cost �.......................................... Fireplace ............... ......vr.......................................................... .......... ...D � Definitive Plan Approved by Planning Board -------_______________________19________. a Area ..`7 Diagram of Lot and Building with Dimensions Fee. ..... SUBJECT TO APPROVAL OF -BOARD OF HEALTH We, ' OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree, to conform to all the Rules and Regulations of" he Town of Barnstable regarding the above construction. Name .... ... ... 5:." ..`'1'.'' .................: V Construction Supervisor's.License ` �5 DUFF=, JOHN & G. A=325-174 No 27340..... Peri-nit for ................. Single Family Dwelli ....................................................ng...................... Location ..1.8...Old...Fish...Hills...BP9kd.............. . . ...... ........ ...... . . ..................H.....Yannis ............................................. .......... Owner ....John & G. D�Af .................... ....................... Type of Construction .....Frame.......................... ................................................................................ Plot ............................ Lot ... ............................ Permit Granted ...... ..........19 84 Date of Inspection .....................................19 Date Completed ......................................19 61 qo (2., J ' n yofT"Ero TOWN OF BARNSTABLE 27340 ePermit No. .............:.. . BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ■ HYANNIS,MASS.02601 Bond ........X ........ CERTIFICATE OF USE AND OCCUPANCY Issued to John & G. Duf f ett Address 18 Old Fish Hills Road J Hyannis, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY 'THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 1,1ay..1 g!........, 19........�....... 1. .........,.� Building Inspector A .rtwnds�,w^rv�s4f.�tS�'+IBai4q;iri�.;.�'-Wyk'r��f+f`M�.rye:rrw.''8�;'d�'Li'ertfi+`t�`SNwa'o"�iti: +j,"i'i�:'t?'e�'�� +7`c'ye'e+'d'T"�`�1 "•..-kr"'r.,'"._---•—,.r�-•"-' —•rr^• --r^s - ._... � � ,�. gamr�, o�INC TOWN OF BARNSTABLE Z7340 � Permit No. ..:... 4 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ................ i639•��°Four HYANNIS,MASS.02601 Bond ......�sj.`......... CERTIFICATE OF USE AND OCCUPANCY x Issued to john & G. Duffett Address 18 Old Fish Hills Read 11yannis, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD F THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE,BUILDING INSPECTOR-UPON-,SATISF_ACTOR-Y .COMPLIANCE -WITH -TOWN- REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. tiav 3 , 80 �, - � ,r' . j................ . 19................. ,:..:,, Building Inspector e r 71 'y it 5 1�� Lf�111 ^•Oti Ulo^� � �r °.. i'f; '.'d y t' F a PINK= DEPT. FILE COPY/WHITE-FIELD COPY'/YELLOW APPLICANT COPY IL ot IL .,. 6J IL DING,- f TOWN OF.BARNSTABLE, MASSACHUSEUS. PERMIT .._, .. VALIDATION Dec)zber i'19. 84 N 6 ® DATE 19 ERMI NO. Nick .Lagadonos Tian u LPn. , ;Cotuit - 53 APPLICANT. ADDRESS }. (N0.) '(STREET) (CONTR'S LICENSE) PERMIT TO Build dwelling ,.__�_.1L OF ).: STORY Single. family dWelling.. NUMBERDWELLING UNITS. 1' `) (TYPE OF IMPROVEMENT) ZIN0. ' - (PROPOSED USE) ZONING AT.(�ocATlor1) 18 Old Fish' Hills Road, Hyannis DisrRl CT_ RR .(NO.) (STREET). .'.. .... - .. - BETWEEN AND (CROSS STREET). - - (CROSS'':,STREET) , LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT;'IN HEIGHT AND SHALL CONFORM IN.CONSTR'UCTION P O TYPE USE GROUP BASEMENT WALLS OR FOUNDATION' { .. (TYPE) 1 Town .Sewer, Permit 41.758 REMARKS?` BAND AREA OR 1468 sq r f t• .._ i.,. 40,000. PERMIT ,84.75.: VOLUME ESTIMATED COST $ FEE . (CUBIC/SQUARE,FEET) : John & G Duffett l 4A OWNER' r ADDRESS 869• Pl$in.St• touhton, `1 BYIL G DEPT v �b'�FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE ALL CONSTRUCTION WORK: INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI To BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS .2 _ 2 _ 3 Ckqs HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT • 1 OTHER 2 �v ' n 1 r �r p BOARD F HEALTH a WORK SHALL NOT PROCEED UNTIL THE INSPEC- P E RM I T W!L L B E COM E N U L L AN D VOI D I F CON ST RU CT ION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTFIS OF DATE THE ARRAAGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION I PERMIT 15 ISSUED AS NOTED ABOVE. NOTIFICATION. C� �j2,0,P L-oY'74 l 0)000 o � 220 4 q I 0 2Q �o j NpaTiep N N d� l co • ®O o �- 1� �►s� 1 LLS I CERTIFY THAT THE FOUNDATION SHOWN DOES NOT VIOLATE ANY EXISTING ZONING REGULATION OF THE TOWN OF BA-R IJS' F" F3 OF M4ss�cti WALTER P. OLDHAM N ,A No. 23207 O �Nv SUR T70 U N ITT 1 O/J CER"rt ricAr/Off-E-105 EN�R•A�,oc s �Nc. RAyAJAAM �t,ALE 1 - JCS 1 , M34 is _ �J 7-7 { S�Assessor's. map_ and lot number . : .....: _ X ?HE Sewage Permit number A� a17s� '✓p? i 4 r T Z BA"STADLE, i e j�`House number:..... ..... �8 . ti Me s +. 9 19. . ,, r .f � �YFY a• TOWN OF RARN:STAB.LE . o x .. �. �. B111DING 1NS;PECT,OR i�,= 61r APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION .....:...... 1..... ....... ......... ................................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for permit according:to the following information: Location ...............01,11 .....F � ... .J Z., t. :. . :�t� . . Proposed Use ...... ' . �i: ,. 'ls(,ij .... ...£....: Zoning 'District ........ ....... ........Fire District A--- -. l.C.4.9.. N.: .S Name of Owner :fS : .:!- . : . ..�..}:ill~ �� <'K` ddressi•jq rl• ..�. �..... .(.. Name of Builder °. .�!4X...1.,A. .......................................Address .4-27.: :ANX.9u .......L .4.7......... Name of Architects.: ....:..�„( .� .Q:1,�L. .....° Address :::.. �..C,J .. ... /.'l...p .. .. Number of Rooms ...... :.:.::Foundation ...°. ...................................... ... .... .. n?. `". Exterior .....: ...:.....WAV.[?.-0..:...... .... ..... ..Roofing ...... Floors ......... .... . .. �...... r .... of C�~I Heating .... : (rt. PTumbing l?. ............................. .... ...... . Fireplace �'da .............................................. ......: ......Approximate Cost ... t 7. . ............... . .. .. t a Definitive Plan`Approved by Planning Board _ _'____ _________ _____19 C Area �J.� ......... . S r � --- *. L Diagram-of Lot and:Building ,with 'Dimensions Fee .........°... ..°. .°. .... . ........ SUBJECT TO APPROVAL OF BOARD .OF HEALTH �• �//VP,) , Z , p Jr OCCUPANCY PERMITS REQUIRED FOR 'NEW DWELLINGS. ` I hereby agree to conform to Pall the`' Rules and Regulations o Town of Bar stable regarding the above construction �e s ,. n rvi ce� upe o . ..............................Con'struct'io' S •s is Li 'nse.o/ ��'�T DUFFETI,.JOHN & G. FS1<lo 2734Q..... Permit for .. ? .'-2.A5.tQ-KY.......... , 1_ Single..Fami�,y..i?WRI.� l� . ......... �......................... f�is pp - r yp Location ... V...Q�d. a.s .Ii�l1S.. C�............ r A .......... ........................ ...f.......... ,• ^j _ . Owner . : 1)uffett... ...................... Type of Construction ...Free................:........... i ......................................................................... 101i Plot Lot .......................... _ f � • x r •.r,. ,t 1,, +^�/ ' - -, y.. ' Permit Granted Decemberz19r.. .....1.9 84 Date of-Inspection........ Date Completed Ali , a A s i t: �aFYt+Era � Town of Barnstable *Permit# Exp' tont6s frail issue date ;. Regulatory ServiceS F s uA1tNSTAB MA&S- h1A83" � p� Thomas,F. Geller, Director i63 ATfo� 2009 Building Division r0�� OF SARty Tom Perry, CBO, Building Commissioner 74BLE 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address dResidential Value of Work Minimum fee of$25.00 for work unde $6000.00 Owner's Name& Address &,�111 r Contractor's Name i.��!-�� �f� Telephone,Number—, pp_4g-09 W-:,w Home Improvement Contractor License# (if applicable) 0A01 1 Construction Supervisor's License#(if applicable) qc jb j ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [�I have Worker's Compensation Insurance Insurance Company Name Workman'sComp Policy# L)CZ'bIS SI) e6% ® o2_9� Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) [�/Re-roof(stripping old shingles) All construction debris will be taken to "�✓�-2/ ��^� � f'��L El Re-roof(not stripping. Going over existing layers of roof) Re-side. r ❑ Replacement Windows. U-Value (maximum .44) *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. Home Improvement C n actors License& Construct Supervisors License is.required. SIGNATURE: Q:\W PFILES\FORMS\Express\EXPRESS PERMIT.DOC Rcvise060409 ri The Commonwealth of M,assachusetts. Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ` wwH.mass gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Elei iricians/Plumbers Applicant Information Ple 'riot Le 1 Name(Business/ 'on/individual): Address. h City/StaWZip: qAAAIW)' �'A Phone-M Are u an employer?Check the appropriate box: Type of project(required): 1.Lam! I aim a employer with � 4. 0 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 K Demolition works for in an aci employees and have workers' g Y capacity. 9.`Q Building addition [No workers'-comp:insurance comp.;ncr,ran # required.] 5. 0 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.GKoof repairs insurance required.]t c.-152,§1(4),and we have no employees.[No workers' 13.[]Other comp.mcnrance required.] ; .. 'Any applicant that checks box#1 must also SIl out the section below showing their workers'compmnsation,policy infornmtion t Hotnwwners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContmactors 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. tf the sub-contraetors have employees,they must provida their workers'coup.policy number. lam an employer that isprovid&g workers'compensation insurance for my employees"Below is thepolicy and job site' information. Insurance Company Name: t: �" r• AA— Policy#or Self-ins.Lie.#: ULS 15 3"16 0 4 CQ9 Expiration Date: Z Job Site Address: '1 +� �� CitylState/Zip:'� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date) Failure fo secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a , fins tip 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 thg violator., Be advised that a copy-of this statement maybe forwarded to the-Office of Investigations of the DIA for insurance coveraae.verification: I do hereb der the pains•and pen edury that the information provided above is&me and ro era Sim Date: 2- P Phone# cDd� `'er7 C b WO Official use only. Do not write in this area,to be completed by city or town qf,j`ckL City or Town: Periait/License# Issuing Authority(circle one):. 1.Board of Health-2.Building Department 3.City./Town Clerk,`4.Electrical Inspector S.PIumbiiig Inspector 6Other ' Contact Person: Phone#: 5 'THEr Town of Barnstable Regulatory Services vHARNS'r LF, Thomas F. Geiler,Director E%6 Building Division m Tom Perry,)Building Commissioner 200 Main Street, Hyannis,M.A 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 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 o Job e 5 tore of Own r Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. n f Town of Barnstable g Y Re utator Services �. s.�xxsrasze Thomas F. Geiler,Director r�wss. Building Division pTFO Tom Perry,Building Commissioner a 200 Main=Street—Hyannis,MA 02601 ",".town.b arnstBble.tna.us Office: 509-962-4038 Fax: 508-790-6230 HOIKEONNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The cturent 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 StlperVlSOr. DEFINITION OF BOMLONVNER 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) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other, applicable codes,bylaws,rules and regulations. The undersigned."homeowner"certitites that.he/she understands the Town of$arustable,Buildi.g Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signatilrc of Homeowner Approval of Building Official Note: Three-family dwellings containing 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 homeownerm perforing work for which a building permit is required shall be exempt from the provisions of this section(Section I09.1.1 -Licensing of construction Supervisors);provided that if the homeowner rngages a parson(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 assuring the responsibilities of a supervisor(sex Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homcowncr 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/ccrtification.for use in your community. 1 ' ,r A l .►a�<<cl�usatt.:='Dal�artmerrt tit'Pw it Buai tl at Bu�i�>im_R4e ulatious and Stand. +t �G�a.3,'..1,t yh. �„•`''aa ta.,Y L�^I-i + _ G ieense: CS SL 99167 'Re rifted to RF%3 OLIVER KEL[Y `' . 9 PEREGRINE_tANE' h SOUTH YARMOUTH{MA 02664. Expirat�an,.9(28/2011.: T"; 89167 Boar o ui Wgg egul s a 'on an an ar s One Ashburton Place .- Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 128957 Type: Individual Expiration: . 6/14/2011 Tr# 284841 Oliver Kelly Oliver Kelly 9 Peregrine lane S. Yarmouth, MA 02664 Update Address and return card.Mark reason for change. Address C Renewal Employment Lost Card DPS-CA1 Co 40M-08108•DB�S1JF0�RR,,,�M�CA108212008 ,�''(,,� �\ BoaofBuil�inoantsn a8V ids License or registration valid for individul use only. T HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 128g57 Board of Building Regulations and Standards One Ashburton Place Rm 1301 o Expiration: ..6/14/2011 Tr# 284841 Boston,Ma.02108 Type Individual Oliver Kelly Oliver Kelly — - 9 Peregrine lane - _ _ G±.�•��. ------- - -' South Yarmouth,MA 0266-4 Administrator Not valid without signature WE'D H:28 Al a�8 :18 t218 4RUN, � '�_� Ida 1/I4l2009 9 ' APAGy 0021002 LMG +� l.ittt M.11:11w;a Group ' F.Q.&tx 9W : i0ouer.NH 03821.9090 f Mutuffi. f dcpbmc(8=653-7$93 Fax(603).243-5330 14,2W9 - �_ 1`:�*�FF9I.;yiOLpIT•i �4 ,, -�-.��:;�`" .. --- i-D 7--j4 HALL SQUARE :�;.- f;xtiltcate tie Workers Ct►mpr�uatiott�swr�tica QLt4MI=, Y . n PERFASRINE LAVE SOU TH YARM©UM MA 02664 Number: WO-SIS-SM04-020- Effective- 2:f?J3/'�408 itsctm: :2ZjZ8/ZOQ4 ,esr„e afforded under IX-Ior tees SLmr enmation IOW of the folowing sta-4s): sa um By Aecidaat± �0d 000 Eadh Arucid�at.� rat.vF�orlse�'.co np son peep does sibs provide del uijt:rfbyDisc"a: $I00.0w !;ardt Parrott vciagefoe ~:oily?si?ury by Dtyeas Sp(},pp() Polity Limits ALx'JE�St►' !-Y s r°.Ws date,die�Axrea-referenced policybolder'is insured by Liberty.Mutual Fitz Insurance C•o wa policy fisted above.. insurance afforded by.the 6ted pohry is subject to sll the teens,endusions acid=ditioas,rMd is not _•;ad b f nay ta��ui=esnenti tear or condil oa of my o-other documents with respect to which this _•f etc may be issued: :%";dficate is issued as nts Mr of iafoms3tio:i aptly end eon`=ems Sao rieY,t upon pour the ca�t>ficate :lr_: 7hscectsfic�izisnoz.srt"insasactpcjicjrs does.fiat tsne:►d,exne, ossiteEZhecomae ngzd by odic poky lis led aboYC. r ,- -i poltey is cmccdled before the stated eypirati- :late,Lbrrt'f wlutLut cmd v..s to no fy VOL:h iL tch ouicetiaiiorl, s 6,t JkLrPHQP&RD RW.BMtATM- - T WCBGxow :..cc,$,esat�faxxaedlfj*7mF�i1•'.d1T[LiAt.3tdb93AA;CEGR V aem slThlL6nnoC09�$"a aededbf:LOf6Cemmdn ls'ltslttEl�: 1 SSG Of Record t rEA I ELE.Y SEA'vDPIPYA LNSIL CE AGB iCY INC F-Gm\..E Lglv'E - 12E?�TERI°RIS"E ROAD :=-; ;rHYA3tMQLTI4 MA 026644 xYAi�RarS, ►�fA. 026Q7. /