HomeMy WebLinkAbout0015 ALBERTI WAY i
r L .
r
y
e
n �
71
..F �'S � �� a ..a�� �.+�•6 .5,-. .. u7
5
e ,
s -
r'
,
F:2
s -
1 w
Y
v 4
uoliv
e
14
d fd xr . _5•. ,y. y. y ram. .E r R �r
c ,
'tn's
,
s '.'� ,..s�1 5�ng�,�,:�1�.. ,,•.,. � � � ". � 5i ,. ;� it <, ��� _ .F Y xl. 'a' �
a ,.., u.=. °s ya c apt .` �,�• , .. ,. 6#'"' a. ;Y• � :R :s,' ,� _"„ ` ,� ,
rr"�a ar 'a,..,- nr•..,.�,. n ri� '._,y' $.° ,•,.e r t.' �`�y• �. ..F -
..' 5. , .� p ,,,� Mom,:. �._ f f Y #.. •,f.-. �f ,#�.
t:
fY
.x .'q $ ai ,: ,Yst+'t�L' :3s= _:a^, .8--..y r ,," M• r ,y P' a. _ '* �,�'.�.
mk
17
-
v
„
h „
T's' "�•l;eT .�m .P � ".� �(i �; .p5 � v.�s w" a:ey,c. � .:¢ry. �i, '.4 Z _ - rF �
y,y
,.. �'. - ;. �J. �x 9��® ��, •rF,..\ , ..... :. �y '-•. .tii ,}'" d ..,fit. b�, . r
�-� .o.°.,o.�i1°�,."y, .,... .� .. ...,� .N: 5'. �s.- ... e•�O y.C.�.,4 :d 'P. ,i �..� M .. _., >•. - i �n. ,. � Fi�
r
,r;s,4lIt' ,�;�t:`� _,;x. •��'� '1 � � 5 y ... a.. .a ,a- .
a `a ,..;,, w.+ ,w'r ;rave
�, l ,,µg M1F.-�j' 4,. -..N. -.. �. '�..�.ya� .1 .� `2',w, i'[•.� u� :... p y aj , � Y .*
x bb
,.Y as.°, ZNrt �� : M- �.rx: .. -
.a ,",: c:
h ai. '� F P,. oar° ..M1Sr.,5. '.d'r-%�'r.. v .,'. �g.. p�..�..
°
AA
L::xr.� 'd
5 .. h ;-�;- z, � a ...•- v:,w ... �e�L's' t.-; °�& "�,: °r,'®YYn` �' .;F w�'x �.�,�:�:. f}. r<w '' •#�Y4 c,. a �.
•a.,� K, a-., .z a ..- h t!e , :. �q o. ..'+•r.- -.
� w
c .i'..� ,,� - Y. a��+, t�s �.,..,. :A � !�.�4 'w a ,,4•;'..rc' �i. �iF1' .. Y'rc�.8'Y. � - �'1 8 �����
-v:- •. f .rr$,' ., c'iT ',;.°* '•, '� N., a•�5:r%` a -tl °,t .t> ¢ ,w .. a'c ..
'Y 17 L qY' � ,[d� O _ � 'J�'dP,f ..� � .,'j x ,. 'r. ., •C�" _�. 4'Lx' .. '(F �` - �1 ..
t.
� v Y
' 1.. �. ,%� �s. �i: .i:"...�•b -�r�.��e'F,r"SiF:S1,. •rt� �."q. -d+?�'!x' :Ftl..irl' '� . _ 'a'' ��� -- S -
f
P
,
'
C ,
,
1,
r'
l • a µ..
1 .
. n
cl „
r ,
• x. T
e
V �
• t
c
2
a .
s +t -
1:
a
z '
N —
F
r
• ''�. . .. ,- �; - . _ - -fie:. '
•
o ,
• r - y a
t ,
4
c •
�• i
Y 4 M
_ .-4 �' d .2- „ „ w e FF. ' -. - .
P ti er ,yy 1AA at
ffiIsAl
a G'
y_
ci
- S mac e
c
e
c ,
is
F to Town of Barnstable �4 Building
Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept
tKAS&
. .� Posted Until Final Inspection Has BeensMade. ��Tyll. ��
Where a Certificate of Occupancy is.Required,such Building shall Not be Occupied until a Final inspection has been made.
Permit No. B-19-1566 Applicant Name: DAVID COLLINS DBA COLLINS GENERAL Approvals
CONSTRUCTION
Structure
Date Issued: 04/13/2020
Current Use: Foundation:
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/13/2020
Sheathing:
Location: 15 ALBERTI WAY,CENTERVILLE Map/Lot: 248-241 Zoning District: RB
Framing: 1
Owner on Record: MAREGNI, KAREN Contractor Name: DAVID COLLINS DBA COLLINS
GENERAL CONSTRUCTION 2
Address: P O BOX 434 _. 1
CENTERVILLE, MA 02632 Contractor;License: 128799 Chimney:
Description: Siding/trim Est. Project Cost: $22,900.00 Insulation:
Permit Fee: $ 116.79
Project Review Req: Final:
Fee Paid: $ 116.79
Date 4/13/2020 Plumbing/Gas
Rough Plumbing:
Final Plumbing:
i
Building Official Rough Gas:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.
r + Final Gas:
All work authorized by this permit shall conform to the approved application and theapproved construction documents for which this permit has been granted.
All construction,alterations and changes of use of any building and str}uctures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and-shall-be-maintained-open for public inspection for the entire duration of the Electrical
work until the completion of the same. Service:
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Rough:
Minimum of Five Call Inspections Required for All Construction Work:( _
1.Foundation or Footing
Final:
2.Sheathing Inspection
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) _ Low Voltage Final:
6.Insulation
7.Final Inspection before Occupancy Health
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final:
Work shall not proceed until the Inspector has approved the various stages of construction.
Fire Department
"Pers tracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:
�o
Building plans are to be available on site
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
4?
App lication number.. -.I.�.�.'.��.`.
Fee ......................I...I.......::........................................
` Building Inspectors Initials.. ................
MAY 0 8 2019 I
Date Issued.... �f 3.... .......................................
ABLE
Map/Parcel...............:....................................................
TOWN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
ROOF/SIDING/WINDO W S/DOORS/TENTS/STOVES/WEATHERIZATION
PROPERTY INFORMATION
Address of Project: /� �j ( /A -1 k(v, P
NUMBER SIRE VILLAGE
Owner's Name: fen 1,�</Q ,e �j M c" Phone Number y'_ 7 -,Va
Email Address: Cell Phone Number /- ov,,� t
Project cost$ --Z Check one Residential commercial
r -
OWNER'S AUTHORIZATION
As owner of the above property I hereby authorize c(
to make application fora building permit in accordance with 780 CMR
Owner Signature:
TYPE OF WORK
L�Siding ❑ Windows (no header change)# ❑ Insulation/Weatherization
❑ Doors(no header change)# Commercial Doors require an inspector's review
❑ Roof(not applying more than 1 layer of shingles)
Construction Debris will be going to Lit
CONTRACTOR'S INFORMATION
�� t
Contractor's name L�Ui t (a-7 M
Home Improvement Contractors Registration(if applicable)# 3 7 (attach copy)
Construction Supervisor's License# (` S 0 7 3 (attach copy)
Email of Contractor .T,?Q fZ&i Phone number �( �`�� ( 'y5✓
ALL PROPERTIES THAT HAVE STRUCTU ES OVER 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 n
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
a -
Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent
Fuel source being used LP tank 20 lbs. or>Yes No , if yes, a gas permit is required.
Natural Gas Yes No , if yes,a gas permit is required.
If food is being served at your event please obtain a Health Department approval between the hours
of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval,
*WOOD/COAL/PELLET STOVES
Manufacturer# Model/I.D.
Fuel Type Testing Lab
Offsets from combustibles: front back. left side right side
HOMEOWNER'S LICENSE EXEMPTION
Homeowner's Name:
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 S
All permit applications are subject to a building official's approval prior to issuance/
I`
y
' QNThe Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street`
Boston,MA 02111
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information ` Please Print Legibly
Name(Business/Organization/Individual):
Address:
City/State/Zip: J Phone#: SZ E ---D Y S ' 0 a Y S`
Are you an employer?Check the appropriate box: Type of project(required):
1.El 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
l 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. 10. Electrical repairs or additions
required.] 5. ❑ We are a corporation and its ❑
q ]
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.[1 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.
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 Afider the pa Rs andpena of perjury that the information provided above is true and correct:
Si mature: Date: j
Phone#: .2 YS U
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#:
r-
Information and Instructions
I
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or-commercial venture
(i.e.a 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-MA.SSAFE
Fax#617-727-7749
Revised 4-24-07
wvvw.mass.gov/dia
I
Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Constrwti'riri' apervisor
CS-073547 ires: 12/07/2020
DAVID W COLINS
20 PICCADILL*-RD K is
SANDWICH MA 2563 N
Commissioner
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
Individual
ENiratioII
3 /-09/41/2019
DAVID COLLI A
DB/A COLLI INSTRUCTION i
DAVID COLLIN <'
20 PICCADILL
SANDWICH,MA .
Undersecretary
COLLINS GENERAL CONSTRUCTION
TEL 508-833-9676
DATE:2-20-19
NAME:Karen Maregni
ADDRESS: 15 Alberti Way
Centerville Mass 02632
TELEPHONE 774-487-2406 email cck15@comcast.net
Strip entire house of clapboard,cedar shingles,rake boards,fascia boards and corner boards.
Remove all gutters and down spouts.
Front of house.
Install Hardie Plank Siding.
Install Azek trim boards this include Dormers.
Windows will be trimed and window sill applied.
A vapor barrier will be install under all siding.
Azek trim will be install around house this includes garage door,corner boards,rake boards and fascia
boards.
White cedar shingle to be installed A's quality.
New powder coated(grey)bulkhead door to be installed with new PT wood stairs leading to basement.
Lead flashing to be installed on sides of chimney where none exists now.
Install white seamless gutters and down spouts on entire house.
Includes permit/dump
Doesn't include any electrical or painting.
Total cost$22,900.00
Deposit$10,000.00
2°d payment%complete$6,000.00
Balance on completion$6,2900.00
AUTHORIZED SIGNATURE
Note-this proposal may be withdrawn if not accepted m 60 days
ACCEPTANCE OF PROPOSAL eV
Deposit will be considered as an a tan
Mailing Collins General Construction 20 Piccadilly Rd.Sandwich Mass.02563
�pF1HETpk� 'Town of Barnstable *Permit
Expires�P Expires 6 months from issue d
Regulatory Services Fee
+eBARNWABLE,
9p MASS.
�0� Thomas F. Geiler, Director
00k 42As
al fD MAt A
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
p Not Valid without Red X-Press Imprint
Map parcel Number
Property Address
csidential Value of Wo411 _JF-- '0w Minimum fee of$25.00 for work under$6000.00
Owner's Name& Address &re rl
Contractor's Name_ Telephone Number
I lome Improvement Contractor License#(if applicable)
Construction Supervisor's License# (if applicable)
❑Workman's Compensation Insurance
Check one: SS PERMI
❑ m a sole proprietor
1 am the Homeowner 200q
❑ I have Worker's Compensation Insurance APR 2
Insurance Company Name _ rn�N OF BARNSTABL
y �-
Workman's Comp. Policy#
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 34f�
v � P
❑ Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders. 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.
A copy of the Home Improvement Contractors License is required.
-
SIGNATURE:
).'\k I'I-ll1S\l ORMS\building permit forms\EXPRESS. c
Revised 100608
i
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations' .
600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organizado ndividua] ' 440 V, Y---,
Address: I 0• Y3co,, 4 -3`-I• w0 L
/� " 11 _
City/State/Zip: l _6-�o�Vl b c Phone.#: Qc�— `�� �'0
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ 1 am a general contractor and I
* have hired the sub-contractors 6. ❑New construction
employees(full and/or part-time): '
..2:❑ I am a sole prpprietor or partner-' listed on the attached sheet. 7. -❑Remodeling
ship and have no employees These sub-contractors have g, '❑ Demolition
workingfor me in an capacity. employees and have workers'
Y P h'• $ 9. ❑Building addition
[No workers'..romp.-insurance comp. insurance.
r,,uired.] 5. ❑ We are a corporation and its '10.0-Electrical repairs or additions
3. I Yam a homeowner doing all work 'R Oo officers have exercised their I LEl Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0f 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.
2Contractors 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 amployees,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 io secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fin(;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 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 certi under the pains-and penalties of perjury that the information provided above is true and correct:
Si Lure: Date: _
Phone#:
Off ial 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#:
L
Information MV
and Instructions
Massachusetts General Laws chapter 152 requires all cmployees 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 foregoingg-engag in a jom-enferpnse;�in g the legal-represenfative3�f- deceased employer,aithe
receiver or tiustee 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 insurace
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-contiactor(s)name(s),$ddress(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 fo any business or commercial venture
(i.e.a dog license.or permit to burn leaves etc.)said person is NOT required to complete this affidavit
The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call
The Department's address,telephone-and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
TO. #617-727-4900 ext 406 or 1-977-MASSAFE
Fax#617-727-7749 i
Revised 11-22-06 www.mass.gov/dia
THE Town of Barnstable
t���
Regulatory Services
• Thomas F.Geiler,Director
EARNSTARr�
aswss . g .
�PrF16 Building Division
Tom Petry,Building Commissioner
200 Mairi:Street;--Hyaimis,MA-'02601 _.._. . . _._.._.....
www.town.b arnstable-ma.us
Office: 50 8-862-4-03 8 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: y
JOB LOCATION: I f �.�A 4e P-o
number street village
"HOMEAWNER". CL,2 i
'Arne p/ home phone# work phone#
CURRENT MAnJNG ADDRESS: 1 " V` O x 4 T 3
cityhown 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 siructures 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"asses responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations, f
f
The undersigned."homeowner"certifies that.he/she understands the Tpwn of Barnstable,Building department
m3niraum inspection procedures and requirements and that he/she will comply with said procedures and
reqLurpments. '
Signatiae 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 bormtowoer performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 1D9.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages 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 an assuming the respom'bilities 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 priori as it would with a licensed
Supervisor. The homeowner acting as Supmvisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her respam"I nlitirs,many communities inquire,as part of the permit application,
that the homcowncr certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form cuncntly used by
several towns. You may care t amend and adopt such a fomnlce'tification-for use in your community.
:fbTnu:homccxe
Q mPt
r-
THE Town of Barnstable
° Regulatory Services
pM, $ Thomas F.Geller,Director
0.F1 16 Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section �t
If Using A Builder ,
as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work au rize by this building permit application for.
(Address of job
Signature o Owner to
Print Name
If Property Owner is applying for permit please complete the
Homeowners License Exemption Form on the reverse side.
O:FO RMS:O WNERPERMISSION
,STY[ - TOWN OF BARNSTABLE Permit No. „..34672
l •f BUILDING DEPARTMENT Cash $524.00 7q7-
"';M. TOWN OFFICE BUILDING
�'>tar�r► . HYANNIS,MASS.02601 Bond ................
CERTIFICATE OF USE AND OCCUPANCY
Issued to BERNARD L. & CARMELA ROSATA
Address lot #3A 15 Alberti Way, Centerville
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. j
July 15 92 ��� _.�.
19................. ..... ... ..e�!..,..................
Building Inspector
TOWN OF BARNSTABLE permit No.,,,,34672
I BUILDING DEPARTMENT ".
TOWN OFFICE BUILDING Cash $524.00
�Yl
HYANNIS.MASS.02601 Bond
................
CERTIFICATE OF USE AND OCCUPANCY
Issued to BERNARD L. & CARAIELA ROSATA
Address lot #3A 15 Alberti Way, Centerville
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. /
/ r
July 15 .......... 19................... ..A
Building Inspector
ARNWAM
BUI8810NER8OFFlCH
PAYABLE TO: DATE:]
Bernard L. Rosata
AccToI a r a ao�05
50 John Street VEND
Needham, MA 02194 °
AMT.
PO#
APPR
A
J�
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR .
QUALITY ORIGINALS)
I m
D ATA
1
rkR
/,TOWK OF BARNSTABLE, MASSACHUSETTS +'�
A-148-241 DATE Novi.LLiL.;:[. .i 19 9l PERMIT NO.
NO;APPLICANT JOhn H. ROBata ADDRESS 50 John St. , Needham, - P O l7
(NO.) (STREET) (CONTR'S LICENSEI
'PERMIT TO Build dwelling ( 1 ) STORY Single fiimily dwelling NUMBER OF 1
DWELLING UNITS
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE) -
AT (LOCATION)
lot #3A 15 Alberti 'day, Centerville ZONING* RIC
DISTRICT—
(N0.) (STREET) i,:
y 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 CONSTRUCT
44 TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
;aREMARKS- SF'wage #91--26
q (Bernard L. Rosata): $524.U0
AREA OR 1140 5q. ft. 60,000
VOLUME ESTIMATED COST $ FEEMI . $ 82.00
(CUBIC/SQUARE FEET)
Bernard L. & Car*tlela RoGaLa
'OWNER l
ADDRESS John t. , eel nam' t1& O 'I94 BUILDING DEPT.
BY
{
a {.
l ro
TEMPORARILY C
MUST
CODE
-.:.::_._. �- _�.._:�...:.::.,.��•,..._ :-.c - Nc RS MAYS BE OB MUSTBE
F�-OM`TF�'-D PXq fi'ENT OF'-PUBLIC•WORKS.�THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM,THE CONDITIOI
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
.�,`A L'L CONSTRUCTION WORK: ELECT-R-ICAL; P-L_UMBING. AND
-T.: POUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURALIQUIRED,SUCH BUILDING SHALLNOTBE OCCUPIED UNTIL
FINALMEMB INSPECTION
TI TO LATHE 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
-ri
2 2
2
7',
� HEATING INSPECTION APPROVALS;° I EN ERIN DE RRTMENT
s t BpQRD OF HEALTH /
' OTHER SITE PLAN REVIEW APPROVAL
y
WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT 'W!LL BECOME NULL AND VOID IF CONSTRUCTION
ON
TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE,THE INSPECTIONS INDICATED ARRANGED FOR BY TELEP EP THIS CARD CAN
CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. THIS
OR WRITT:
r. NOTIFICATION.
L
A` I
N
39 ss E
Ce7, 87 '
o PLAT ?-48
0
o LOT 2h
� ZZ4 S. F.
M
N
�0 3r
Z.35r z.3
oC v 44
c
Z& r ---,/
Mo N 4'
L1( 13
W
Top FND.� -
N G.3'
EL,= 101.7Z
00
N
P
3 a GARAGE 1 '
0
ZZ. I '
aD
0 I N N
DRAIN
EASEMENT
t o z . OO r
2G.pp s 1z,
39' SSrr .� I
S1
= GERTI Fy TWA-r THE Loc.A
AND E(-rvATlon/. oF. THE
EFoWDAT ot4
5NowN ON TH iS pC A+., ARE
AGCvfZATE AND: I N AC-Lop PA NCE
wITR 7-wN` 6y _ LAw8 .
1
`r ��ti1M u f
/v GERALD �N
MICHAEL A S BU 1 L_.T FOUL D
�F? AT"IoN
��� rnzr,ERnt_a
4�` A NO 193.33
CENTI RVI
9
MA .
hp S �
'A �-• //;; F o R
!11 B RNARD ROSATA
GERALD M. FITZGERALD SCALE: 1 r�� 2® � ocroBER 30 , I�t�l
13 CHURCH STREET
MATTAPOISETT. MASS. 0273,9
Asessor's office(1st Floor): %T y/ / S'E�'(���'��*�•� ��,6, O`TMf T
Assessor's map and lot number 11 ,'�§.r��L�®���®�������
—Beard of Health(3rd floor),
Sewage Permit riumber WITH TITLE 5
ENVIRONMENTAL C00�AN D, WAS&DLt
Engineering Department(3rd floor): < 039
House number I.� � ������ �����! .aw °°"�obso•111,
Definitive Plan Approved by Planning Board 19 r�r
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only A P
PRO
1VE D
T O W N -* O F B A R N S AsRLEservation Commission
BUILDING' IHSPEC ine -�
APPLICATION FOR PERMIT TO �to l i..p f� S J Af 4,L.E FIa/n J L-Y 140 U S l� Date
TYPE OF CONSTRUCTION LA) 60 0
07.�. 19�r
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location a 7 .3 A /4 L 6 ge i
Proposed Use n`(P
Zoning District G Fire District O plf oq
Name of Owner"30reyARno i. - - (ZAR CI-t1 TOSAMAddress S'6 J 014#44 S V A/Ec—ODAVAIM. _MA. o:ZJ 9i
Name of Builder H tq 14 Address �U ����Y -S'! �' a���! /?i/,¢
o��2Y
Name of Architect L4 GO Address 0-11 J4-'r<'•'d'4 114 A
Number of Rooms f7 Koor*-1( 5 Foundation C 6AJC R9-
Exterior U�M Roofing A i�Gd P F � CA jq S'17112H e_T-
Floors _- 9— Interior L VA 5 Q—
Heating t o eGj�_'V H i 14 !W Plumbing
Fireplace Jy 0 nfe Approximate Cost ��U a O4 i
Area
15� 'y3'2! ' � Y2
Diagram of Lot and Building with Dimensions /Z q_ 30 Fee
13
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
--A'dI4K qoSA-r,4
Name _, �r-.
Construction Supervisor's License Y'Z 7 75
ROSATA, BERNARD L. & CARMELA
No 34672 Permit For 12 Story
<Y C
Single Family Dwelling
Y I I
Location Lot 03A, 15 Alberti Wad
Centerville - -
Owner r Bernard L. & Carmela Rosata s
Type of Construction Frame -
Plot Lot }
r Permit Granted November 1, 19 91 _f
Date of Inspection / 19
Date Completed 19
7/4ce/2-
G t.
t °�
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
Im A
DATA
Ell"41
Fv3a•9+t ,tr.:E
-'--�'\ _1`_ � _ • -'_'_", _ - r' ,� r ram.:
L:
"
7
---'�'--- �- —.-- " :
i
k j
a.-f - r
ltt
-
.�. -
_ l I � -I � al � � '� � - �, � .•/ L� p�.f �34F�'�'.s�sa,
,a
l
. - t� dt ?a :''y '"`:.;.P- � + '` r� c .e�' ,�'' �r 4 •w,'v°g3'e�
��.� - .. rt• j 'Sy K*T ,� ]'S4� ''a.-"6�!.�.-�-t �S 1Y
;>.1'4.:,•rs .._/, �... .-� .>�F ti>`J, 4�:;�-Si'"t�G �a ��,�, 3�/�c-, '?t< r `k.�•.:
..�,.y' 9 :i Lct;'" .�' ' i .l-d:,. 1. .."1'.n- .�• S. Xe: -+E...R'S. •'�'(':S•,n�:-;: %,�`: .sid•� .��
p ..,.-' ...:Y. "_ • r_�.._: �...;,,__. .... . : � �._. ,.as'k.. .-., s w..... ... a_..v,-r ,,....e.�'=.��nr�..'... .....-tia.`+y.`:�!c_,., �-r�. s.�.a�t,
I
-
i�
i
t -
i I
_ I
} - -•' .'�
z
I'I
i
F
wai
------------
/y
4 1
7
..:
G`C$
1
tz
yl
f
a � `
vb `.�. <:.v ����-tom.3'�`I""'-s �`� t..= _ � - F�. .1^'_ � •� �. �� .,�.., o RSe,:,�'. � ..� .�', � I � �fl.
,
- Y. u _,. i.-.'�4`-8".STY{Y_i,'•atrJ.:_..:f�.. .. _S..6C��-:. �" � m' +P. �_��.ka 3'Y:..w�....-': ^r;'�"�3• `'.`' �-.....:_.,M�� ..r.,.-.�•,
t.:. ,..� w:4;•i�n.'r
r
• t .
'j:. to p'i -tv ' `{ ''?- :C' Sy nw' -"�.�•�'r ';�".+'f_H .f — '-YCd'�.s^. -5 y �. . USERSf i
>,-`3xt+4 S"n+- ':_4....�z.-. t - -.4�,:_%"yyt,'',3i i �''•j�� a-t�Cy,�^Si�i � �a. �"`� .A.'av �'k. ��4 a.-''•. S .,,b -`- �� .uz'
q=t .ri- S` 'h- tx n "!e �'�7°z y y'i a p a a T"?,<r-O r fr3' ��.�-yz�„,,�'�-f=-•A I}20.
1 ir$1p e�Lan,
194n4-
ram.,<- - ,.....' ,. ��"•;�K �. ��4 �--P.,� Y.:r.!i G �,-.;.. �7r•a f!®.�: _ �-���M1
SERUM a
{ i
y
};
L10.f-t} rhO
A ,
IV Iwo
t4�
BY
t t
a
r t
7 ,
iP
WAS ' O;
As
Wo
�d IIN
�:. x+ c z,:- h.-i r y. ,• �.;e• �_�.- _, � d z.�lS-.�. �? `',.� :ro { ...�,,rAi �.. -fix...tt-+ate.,, ,�-a�.
t + < s
�„r`.-........
�.�.* $,G`— S +�.: .� '�''$�'; �2. Q L: � .�ti, ,�T.. s,,.-•�/.v �'.,.r?'� 1-'s•, f"s ��!mr.�.,
.E
`� < ? .vl--. _ `k' .t r.n >Fyt 1°jC. r.Yy .:". x. ,va. •..W.
�.�_. :a_.'..-'.�c.b.+�r3.'/_.,:aS'r4,s:i 4tl.'....r-.:.,:i. .. ..._.;.. a�(.e.-..I r;x,r>..:,••ew.,:ua:tt�•,a�a���'�h,i-+,-.�;.�.,-..s?,..:�....'�:�:-,::^.:...::.',���:.-.'..,...- -.,;:�-.,.' -:'._-' .t: ��' t./t,,..�_i,y..q.F.t,�„-ri;p e--.�♦'i'F.,-��f .�`'�F
" , " WASSay
r e+5,'�._^'�- r V-'.i�_".a-:4.Y.�e,-oa'+.:-.s'`.�'x"��i'.,-�:r.r�'',•'�'"f:.�.:: ��s".'E!',�=rv.`�..yw�,,vT...z;•:u?;e'y��._,'xF�l#_"R�.i�:.-d-'•::�'�A;:..e-�4 s..-�'•@ i��.?�.c�,'.4,.�.C''Y.�-r„,tt.ry.-`� .�,�.
�,..
. i
>G ae. ?• . fi t.r� l 5{,a6.q...51 . F ;
nu
MC -
��
�x-h+�- �G+:'•'�'.r� vq, .s t *."„'.. .A � ,;�y F ,�/, x . .. � if.. � �,'*.-`�•.:ti:Stf� - � �f,.. F*s^4,
� •;-,�'�s.°ty� ,�'".�' .F sh r � fi: , - A is � V �,'�"u w a�3 '�Oe f 'u e�� 1i
r� A
77
�.. --%. .'J'A•Af � '.
P.1.24.K2¢
1
a
444
14
3`
6i i
J
(. .�
• � pp
i .
-1
�j2 0
r
Al
-
.:&'W'=--
W.`'RCkq}'(d�M1 ..
t I
t \'I
f. weoD MA Tt.t "j .. F(1 N c4t_c t'- ..
.::45.3:7�r3(c.Awg46.` i "T d. '.2'+G'Cre W- T
CS E
126[Y¢,Gt r .' ! I•cs.,F..c.eclA.
_ � _.__-"____ �C C �-S.�Lecti F'R%.w6 �.A� /' � �
P �� G"+TjER
,..� e e IC".MI�.. .�.lB'MITa, /%' I� :.9:1t.4" C,�p., ... � - .• .So fit=1j' -
�... �NtAaTK: ..e,sy perryp;.r2-2`,ca•ki E s.DHR
!.3'a2f.-
..ALeWL P"T. < ,6TL D Oil Li r
e _
_C G{.r ► E� .S=EcT`� O►J. f y� 4�ebC SylugLGS :..
rca's
ZI xVtLgT�lo T ;,o'I—
Flu
j o w.\ ti
Hlo.T ¢eao Ma,ti Stwtt,;
9`♦1!0 I.,o51r.a.t 1I. K T-Loocz � I.re,.f,lre sKe:s.Tlr,ll,,q
f3aSc:ope
Tna1
" t ,t• t� Tt¢oZ.Soup t3 rz\o�� 4"+r.c'Sr� -
-
'oR �2 G\tRCSE bZ '�•.�g;'o o/rc f3,tF 't!, m i C`i¢
P.A, p,s.,a� - C .�►)� .�rr.p
` \Y, i
X .
P F�� t3ttLew
w mG
-
1
C —T1 a.l ov S Cow.C.
74ti<�O'iC}Q Cot,G"�4q: ` �3 foaTI N r,1 Qtsp-
e-At .2:'G 14,1i� s t WlII 4
.. 38V