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Home My WebLink About0343 AMES WAY � . �._ a _ _ e _ _., _� �� . . �e, F � o ® ` o t,_ �. ` } o o i Town of Barnstable N, ; M Building Post This Card So'T:hat rt is Visible,From..theStreet-;yApp,roved:Plans Must beRetained on Joband'this Card Must be Kept HARri'SC`ABL�, .; ." �a , r s ".' '° .` �x ✓ s ' ` v 6" Poste„d Until Final Inspection Has BeennNlade� k 39 " fit , �:: . .1 a ,1 , - , eb <" WPermit here�a Certificate#of Oceupancy;yisrRequired such Bwldmg'shallNptbe'Qccupied�unt�la,Ftnal,lnspection,has been ,made „+ Permit No. B-19-3432 Applicant Name: Steve J Spengler Approvals Date Issued: 11/05/2019 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 05/05/2020 Foundation: Location: 343 AMES WAY,CENTERVILLE Map/Lot: 170-228 Zoning District: RC Sheathing:. . E Owner on Record: CZUPRYNA, DANIELJ&NAOMI R Contractor Name;"--STEPHEN J SPENGLER Framing: 1 ` i. Address: 340 CEDAR STREET ConlractorLicense; CS=,071546 2 t WEST BARNSTABLE, MA 02668 F �Est Protect Cost: $ 11,264.00 Chimney: Description: Installation of roof mounted photovoltaic solar systems, 16 panels Permit Fee: $ 107.45 Insulation`. 5.12kW Fee'Pa d"' $ 107.45 ` Final: Project Review Req: Date 11/5/2019 i. idt, rr Plumbing/Gas 16 J Rough Plumbing: 7 ui m icia This permit shall be deemed abandoned and invalid unless the work aiathor¢ed by this permit is commenced within six months after iss an�. Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction document or�whi h this permit has been granted. All construction,alterations and changes of use of any building and structures s all be incompliance with the local zonmgby laws and codes. Rough Gas: 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 work until the completion of the same. Final Gas: ° . .- : . The Certificate of Occupancy will not be issued until all applicable signatures by the Buildmggand Fire Officals are provided onthis,permit. Electrical Minimum of Five Call Inspections Required for All Construction Work x Service: 1.Foundation or Footing , > > , 2.Sheathing Inspection 3` 3.All Fireplaces must be inspected at the throat level before firest flue't 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: d ru L.1,- F.rIA- SEA Town of Barnstable Building, 1L e' ostsT is rd So That t�s �sible'From LfieStreet,Anp"roved, tans M`us „e Retamedon' ob and this Gard M,usCf�e Kept ,p •.1A8N8[AKli. r: ��„ ..:. �� j�*.E.� ��r s'; z .r '.� ;.,=___.sjs"'n ,' - +" Pasted ntll£ anal inspection Has Been ad 46 . .. - � .Permit - - �� `� �:W,here Cert�ficatexvf,Occu anc -,is;Re utred,such�Buldin s 'hall Nobe,Ocupied un � a E�nallr�spect�on�has�tieen �ade Permit NO. B-17-2869 Applicant Name: MICHAEL MCCARTHY ., Approvals Date Issued:. 09/06/2017 Current Use: Structure Permit Type: Building--Insulation-Residential Expiration Date: 03/06/2018 Foundation: Location: 343 AMES WAY,CENTERVILLE Map/Loft: 170 228 Zoning District: RC Sheathing: IN Owner on Record: CZUPRYNA,DANIELJ&NAOMI R Con#ract�or Name: MICHAEL MCCARTHY Framing: 1 y Address: 340 CEDAR STREET ontractor License ,.169393 — 2 WEST BARNSTABLE,MA 02668 Est Protect Cost: $0.00 Chimney: Description: Weatherization PermitFee: $85•00 Insulation: fee Paid $85.00 Project Review Req: Weatherization k 9/ a x / Final: y. s 6 2017 Dt I'I , e Plumbing/Gas y ` Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work a #hor¢ed�by this permit is commenced within tWfnonths af€er issuance. 3 -. Rough Gas: All work authorized by this permit shall conform to the approved applahon the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structtires shall be in with the local zoning byelaws and codes. Final Gas: 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 work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signaiures by the Build,in�g and fire Officials are,provided on is permit. Service: Minimum of Five Call Inspections Required for All Construction Work:„h 4 � = 1.Foundation or Footing �•, x Rough: 2.Sheathing Inspection . 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: 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 Town of Barnstable Building • "yv . . = - Re n ob and%th'is<Card Must:' 'e Ke t ostThis, ri So Thatis:1/isible From'he Streets Approved Plans Must be Retained o p, i::1AENSPABI$ �. .' :;'aka'a :,. f ;$ `� ,`�'b 3s/ _•''�L. "3\ K...; -�r �. ;+"' r; -i * osted Until anal spection as-Bee ade y F Permit Occu anc, a wired :such:Bu�ldm shall of be Occw ied uht�!a 1=inal Ins`ect�on:has,been made s +�a Where a Cert y ._...q. . ' .::�...� �,.. dMu.�.. , pnx<.MM. L . Permit NO. . B-17-2869 Applicant Name: MICHAEL MCCARTHY Approvals Date Issued: 09/06/2017 Current Use: . Structure Permit Type: Building-Insulation-Residential •Expiration Date: 03/06/2018 Foundation: Location: 343 AMES WAY,CENTERVILLE Map/Lot: 270-228 Zoning District: RC Sheathing: Owner on Record: CZUPRYNA DANIELJ&NAOMI R Contractor Name: MICHAEL MCCARTHY Framing: 1 , , Address: 340 CEDAR STREETCon�ractor L�ense� :169393 2 WEST BARNSTABLE, MA 02668 � � � Est roject Cost: $0.00 Chimney: Description: Weatherization Permit Fee: $85.00 Insulation: J Project Review Re Weatherization Fee Paid $85.00 q Date 9/5/2017 final: 1 ...................... a x� a ,..�r�wl Plumbing/Gas *A` : _ _._......... Rough Plumbing: a ' .. .., ,A...... ... + 41 z.� asap „ x u uildingOfficial final Plumbing: This permit shall be deemed abandoned and invalid unless the work authbei by this permit is commenced within six months after=issuance. ft a Rough Gas: All work authorized by this permit shall conform to the approved application andithe approved construction docume for w�hich�this permit has been granted. z , All construction,alterations and changes of use of any building and structures shall be m compliance with the local zoningby laws and codes. final Gas: This permit shall be displayed in a location clearly visible from access street&*boad.,and shall be maintained open for p�ubl�mspection for the entire duration of the work until the completion of the same. 01 ' v Electrical The Certificate of Occupancy will not be issued until all applicable signaturesby the 13uildang and Fire Officials arexprovided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work ' 1.Foundation or Footing ' y Rough: 2.Sheathing Inspection `�� 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: 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 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued 1/o 6117 R W e-!e- Conservation Division BUILDING 3EP: Application Fee Planning Dept. Permit Fee d AUG 2 3 2017 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis�° E313`��` �' � Project Street Address 3 Village Owner /�.�,�; Z v J,r-1k g Address S•►1c Telephone Gi >-0- Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ' Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0"' Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name A4ike lGar-thy Constnaption _ Telephone Number Address PO Box 52 ,,,�� 1%4'est Dennis, MA 2�� License # Cell (508) 280-6964 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTI G FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i ,dig FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Town. of Barnstable Regulatory Services , eu9s Richard V.Scali,Director �. b,�o6 L Building Division Toro Perry,Building Commissioner 200 Maims Street,Ilyannis,MA 02601 www.town.barnstablexi2ms Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sion This Section If Usinc,ABuilder I,Naomi Czupryna _ ,as Osmer of the subject propcity hereby aurhorve _McCarthy Construction to act on my behalf, in all matters relative to work authorized by this building permit application for. 343 Ames Way. Centerville (Address of job) Pool fences and alarms are the responsibility`of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. igniiure orner Signature of Applicant Naomi Czupryna Print Name Print Namee _ Date Q;FORMS:Oyv'::ERFER1,41$SIONPOOLS l ' f � / i l�J /, 0 gAz', 'Cke'jetrn e Office of Consumer Affairs-arid Business Regulation 10 Park Plaza- Suite 5170 Boston,`Masachusetts 02116 Home lmprovam i tractor Registration Type: Individual §Z, Registration; 169393 MICHAEL MCCARTHY 1 Expiration: 06/15/2019' P.O.BOX 52 r--- WEST DENNIS,MA 02670 �5 .; - •r„ \ i Update Addressand return card. Mark reason for change. SCA 1 Cr 20M-65/11 —- -----— ---" "j ----- ___.1771 Address 0 Penpwal 0 Fmelo=iant La Card �ie 1pamzinzo�zuse�o�C�a�o�u�elto Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only l a TYPE:Individual before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation s69393 06/15/2019 10 Park Plaza-Suite 5170 RTf`max Boston MICHAEL MCCA;R�'#(�!"-'c`�=v:�!�:; TO1 MICHAEL F.MCCARTY 6 RANGLEY LN. SOUTH DENNIS,MA U2666 Undersecretary Not valid without signature 1 Massachusetts Department of Public Safety Michael McCarthy '`�r. Board of Building.Regulations and Standards ` McCarthy Construction License: CS-058633 r Construction Supervisor k Has successfully completed the National Fiber Cellulose Training Course k i" 23n0 da of August 2011 MICHAEL J MCCARTHY r YP.O.Box 52 .. WEST DENNIS MA Jim 026T0 Wldte.N>ldoilal Fiber iIv F NATIONAL FIBER ^ ', a Not valid unless ambowed i ( ' ,�� Expiration^^� v I r Commissioner 04/10/2018Mom r 1 wli q OSHA 001558712 NeyOf°Sohrrions IJCmrdf°pek rsfmu(sSslJReli°nn „. rafetp/tLrrtu Ijirfcrtifieatiou s "Ir011111111ftO U.S.Department of Labor Occupational Safety and.Health Administration • e" Michael McCarthy r € a Successfully Completing the Combined has successfully completed a 10-hour Occupational Safety and Health Crew Chief/Build mgAnalyst R Combustion Safety P , 1 Course' Training Course in 3z Hours of Class Time and 8 hours of field time fe_1 led ' Constructtoq Safe 8 Health , 9�9�07 _.' IWII.ke,u IyM.Y.J,Nnn.LL,' j1•u.W 4r a,i 16u6..Jl hiau (Date) s The Commonwealth of Massachusetts Department of lnduM4al Accidents t; I Congress Street,Suite 100 Boston,MA 02114-2017 wwlumassgov/dia Workers'Compensation Insurance Affidavit:Builders/Contracters/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. AvolleantIn ormation }� lease Print Le ibl Name(Business/organization/Individual): Address:_- City/State/Zip: we �n�.., oft `Phone#: XO -10 , Are you an employer?Check the ppropriate box: Type of project(required): i,E�Lam a employer with employees(fill and/or part time).i/ 7. ❑New constiuction 20 lam a spit proprietor or partnership and have no employees working for mo in , g• Remodeling any capacity.[No workers'camp.insurance required.) + Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required•)t 9. []4.Q i am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5.[3 I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.0 Roof repairs These sub-contractors have employees and have workers'comp.i nsuranct3 6.Q We are a corporation and its officers have exercised their right of exemption par MOL c. 14.®Other 152,11(4),and we have no employees.[No workers'comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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 oployeas. If the subcontractors have employees,they must provide their workers'comp.policy number. r am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site Wfirinadon. ;nstuance Company Name �� 1-►`��i;�k ��9 r�'� s. J 1 W C-�`�'�52`/ Expiration Date: ?clficy:�oc Seal-ins.Lic.#:" _ fob Site Address: City/StatelZip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verificat[on. ido hereby certify under th an hies of penury that the informationprovided above k true and correct Si afore: Date: t Phone � official use only. Do not write in this area,to be completed by city or town offieiaL 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#: f MCCART9 OP ID: KS CERTIFICATE OF LIABILITY INSURANCE OATE(MM1D°"'"'' 12/20/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 CONTACT Bryden&Sullivan Ins Agency NAME: Dennis Office of Dennis Inc. PHONE .508-398-6060 FAX No):508-394-2267 485 Route 134,PO Box 1497 E-RL So. Dennis,MA 02660 Dennis Office INSURERS AFFORDING COVERAGE NAIC p INSURER A:National Liabilit 8r Fire Ins INSURED Michael McCarthy INSURERB: Construction Inc PO Box 52 INSURERC: West Dennis, MA 02670 INSURERD: 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICYNUMBER MM/DD/YYYY) (MM/DD1YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES Eaoccunence $ MED EXP(Anyone person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JERCT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident) $ $ UMBRELLA LWB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY X STATUTE I ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N V9WC747574 12/15/2016 12/15/2017 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? Y❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additlonal Remarks Schedule,may be attached if more space is required) Michael McCarthy has Opted to Exclude himself for Workers Compensation benefits. CERTIFICATE HOLDER CANCELLATION CAPELIG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS. Box 427 Barnstable,MA 02630 AUTHORIZED REPRESENTATIVE C 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 'MCCARTHY RUCTION CO „ {veSid tial and Commercial Builder I,�AZE'AIZATTON SPECIALIST { Date: �O I Building Commissioner Town of_bw—Nk�Ti✓ RE: Insulation•Permits To whom it May concern; This affidavit is to certify that all work completed for permit application# Status A; Parcel4� Permit Type RADD and issued on 1l has been inspected by a certified Building Performance Institute (BPI) inspector.All work performed meets or exceed Federal and State requirements Sincerely, et114U11U0 414 t ichael McCarthy McCarthy Construction TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1-7 ® Parcel'aci _ .'Application # Health,Division Date Issued L Conservation Division Applicatiorj Fe Planning Dept. Permit Fee C Date Definitive Plan Approved by Planning Board cozaw Historic - OKH Preservation / Hyannis - Project Street Address 3'1 13 P m e 5 A-y C rm 1_k-R V 1 01 A Village G N�a R,v t LIIL cs6r 0i r Address6 � w- & Owner ��r RO/U C D /� Telephone 78 I- q/5'g5-57/ Permit Request R.P-m® D t L x t $ rY Al G R—A C g - INTO 1,�D i L ao t N ->TA-« - N ew t� N®o Ai- - �v� ��`��'(� 2��-R-iivsui�l�l�'-�-SN�C'T Vic.{_ ��r2. ��nlS' • , Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay q N Project Valuation ®b 6`s Construction Typed Lot Size Q-C-tt_4�- Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ;d Two Family ❑ Multi-Family(# units) Age of Existing Structure I Historic House: ❑Yes A No On Old King's Highway: ❑Yes ❑ No Basement Type: )4 Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area A.(sq.ft) r Number of Baths: Full: existing ! new Half: existing K rew r70 Number of Bedrooms: existing _new v Total Room Count (not including baths): existing 57 new First Floor Room Could Heat Type and Fuel: ❑ Gas )(Oil ❑ Electric ❑ Other Central Air: ❑Yes W No Fireplaces: Existing l New Existing wood/coal stove: ❑Yes, No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage) existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes XNo If yes, site plan review# Current Use __ -_— —Proposed:Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Nam, rQ.-�� VJ eJQ 2—E L Telephone Number V _ rn is 4 Address '4 5� W H 1 Q H OJ License# l 65-5— �-6/\ T'F Ct\1 I Home Improvement Contractor# l p® a �J Worker's Compensation # MM3 o-71 AN" ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L)1aCZN S_r4i LC SIGNATURE C DATE -7-7 i _ FOR OFFICIAL USE ONLY . APPLICATION# DATE ISSUED _,, _ MAP/PARCEL NO._ ADDRESS r - - 'VILLAGE' OWNER - DATE OF INSPECTION: FOUNDATION z r FRAME " -7 l I Y r L-A INSULATION t /l Ild- FIREPLACE ELECTRICAL: ROUGH = ' FINAL PLUMBING: ROUGH - FINAL 7 H GAS! ROUGH R{.:VI f�i&,P FINAL FINAL BUILDING{ .® 14: ,DATE CLOSED:OUT ASSOCIATION PLAN NO. oFYI 11 Townlof Barnstable y° Regulatory.Services BAANSiAHLF, Thomas F. Geiler, Director ' s. MASS. g 16 �",� Building Division , Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,.MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 } Fax: 508-790-6230 PLAN REVIEW Owner: /40A)C CTT Map/Parcel: 170 228. Project Address 343 4MES l,J -f_ The following items were noted on reviewing: ;. SVy►oKE nETEc�iD2 ?D E3E Ai1>7£0 T•J ,J� ' �2.Dorw t Reviewed by: Date:')19bJ .Q:F6rms:Plnrvw The Cominonrre(rlth ofMassachuset s ., Deportment oflzidustrialAmider'ft Office of Investigations 600'-Washington Street Boston,.MA 02111 ZsyyJ www.mass.gov/d'ia " Workers.' Compens.at ion Insurance Affidavit: Builders/Contractors/Electric ansfPlumbers Applicant Information _ dPlease Print Leib y Name(Business/Organization/Indi'Adaal)', /o ZC 4 W- M'006 Address: q, Wk4 A VJ4 f City/State/Z p:G2�y 1 F �i� �I C Phone #:_S V_3-j 7 Are u an emplover? Check the appropriate box: Type o reject'(-equired): 1. I am a employerwith / 4. I.am.a general contractor and I 6. New construction cEployees`(fiall ana/or'part-time).* have'hired the sub-con:tractors 2-Q I am a.sole propnetor.o,r partner- 'listed on the attached sheet. 7;. ❑ Remodeling , ship and have no employees Theses.ub-contractors have g• Demolition ' working forme.in an capacity.. employees and have workers' Y P ac 9 9. [] Building addition comp.insurance:# : [No workers.' comp. insurance required] 5. [� We.are a corporation.and its 10.❑ Electrical repairs:or additions officers have exercised their 11.. Phisnbin repairs or additions 3.1 1 am a bomcowner doing all Work � g: P myself. [No workers' comp- right of exemption per MG'L 12.[]Roof repairs insurance required:] t c, 152,§ (4),and we have no - . employees: fNo workers' 13,❑Other COMP.insurance required.) 'Any applicant that chocks box#I must also fll'out the section"bolow showing their workers'corn pnsation policy information, t Homeowners who submit this affidavit indicating thcy;arc doing all work and then hire outs:ide-contractors must submit a,ncw affidavit indicating such. tContractors that check this box must attached an adutiona?sheet showing'thc name of the sub-contractors and state whether or not those entities have employees. :If the sub-contractors haveemployecs,they must provide their.workers'comp.policy number. I am an employer that is providing workers'cernpen;ration.:insurance.for my employees. Below is the policy and job site information , Insurance Company Name;. Policy#or Self-ins,Lic.#: "'�� ru Expiration Late 22 C 9, ,JAV � � A Job Site Address: �_) M J_V City/Stafe/Zip4Qj f t,L( L Attach a copy of the workers' compensation policy declaration page(showing.the policy nurriber.and exp.iratio'n date). Failure to secure coverage,n required.iu:der Section 25.A of iiMOL a 152.can lead to the imposition of criminal penalties of.a fine up to$1,500.00.and/or one=year imprisourn nt,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. B.e 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 nrd he pains and penaki .o p.erjiiry that the information provided above is true and correct. - -----.... - Sr n� afire: Phone:#: S 0 6 -7R ( t q // Offteial use:only: Do not at!rite in vhis area;to he:completed by city:or town official. i City or Town: Permit/License.ft. _ -- Issuine Authority (circle one); 1..Board of Health 2. Building Department 3. City/Town Clerk 4.F:lectncal Inspector 5.Plumbing.Inspector 6.Other Contact Person:: Phone.": _._................ TKEr ti Town of arnstable a� Regulatory Srvxc:es • MRNSLABL.� s 9.. Baas Thomas F. Geiler,Director Building Division Tom Perry;Building Commissioner 200 Main:Street,Hyanais,MA 0260.1 www:;tc)wn,b arnstabl e.ma.us Office: 508-862-4038 Fax: SH-790-6230 Property Crier Must Complete.and Sign'This Section If Using ABuilde as 07mer:of the s bject.: ru e 7 P P nY hereby authorize 'f Qd to.act on:my behalf, in all matters relative:to work authorized by:this`building permit application for. eS � � c � CAL ems' (Address of job), .7 � 1 � Sig attire er ate ff .. _._...._. _ _ _.. _ Print Name If l�ro e p rt Owner is applying for perrn t please complete. the Homeowners License Exei!Vtxon Form on the. reverse. side. QRCIIMS;M1 N. PERM:S51011 _........................... Hi i�tt ax I41-1 //t3/Z011 6:4y:4y AM 1'AG>r L/UU'L Fax Server ACORD. CERTIFICATE OF LIABILITY INSURANCE 07/08/2011 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 BETWEENTHE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE.CERTIFICATE HOLDER. IMPORTANT:H the certificate holder is an ADDITIONAL INSURED,the policy(es)must be endorsed H SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the . certificate holder in lieu of such endorsemerd(s). - PRODUCER CONTACT NAME: PHONE FAX GOLDMAN&ASSOCIATES INS. (A/C,No,Eld): FAX. (A/C,No): 4527 FALMOUTH ROAD E-MAIL. ADDRESS: . ' PRODUCER COTUPP,MA 02635 CUSTOMER ID 8: 77NHW INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVELERS DIRECT ASSIGNRIIFNT INSURER B: WENZEL FRAMING INC INSURER C: INSURER D: , 45 MaMAH WAY INSURER E: CENTERVILLE,MA 02632 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHEINSURED NAMED ABOVE FORTHE 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 BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - ADDLSUBR POLICY EFF DATE POLICY EXP DATE - - TYPEOFINSURANCE POLICY NUMBER (MM1001YYYY) .(MM\DDIYYYY) "LIMITS - LTR INSR WVD GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMSMADE OCCUR. PREMISES(Ea occurrence) MED EXP(Any one person) $ GENTAGGREGATE LIMIT APPLIES PER: PERSONAL&&ADV INJURY $GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS-COMPIOP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR' EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WC STATUTORY LIMITS OTHER - WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY YIN UB-073IN449-11 07/11/2011 07/1112012 E.L EACH ACCIDENT $ 106,600 ANY PROPERITORlPARTNERlEXECUnvE N • E.L.DISEASE-EA EMPLOYEE $ 100,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-POLICY LIMIT .$ 500,000 11 yes,describe under DESCRIPTION OF OPERATIONS below - DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES(RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING W ORMtS COMP COVERAGE CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE 367 MAIN ST WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE HYANNIS,MA 02601 Charles J Clark ACORD 25(2009109) 1988-2009 ACORD CORPORATION. All rights reserved. . — �1ass:uiraitirttti- D) part'nacn.t of l uhiic `Id'ctN Board of Biiildi;i; vu:ukltimis and Slanti:trd", _ Construction.Supervisor License License: CS 9055r Restricted to: 00 MARK A WENZEL 46 WHIDAH WAY CENTERVILLE, MA 02632i, 4 Emoir,ition: 6/17/2012 Y ninnit: ii:q,r 1i.,• 26980ZL . •i�lrrurrr:�.:r�a�,la Oflicc of Consumer Affairs do Bitsincss 1Ze{tutntian License or registration valid for individul use only ` before-the expiration data If found return to:. �tt?µ ii I(,-)HOME IMPROVEMENT CONTRACTOR - p 1 �'{�l �'�'Registration 100285 Type: Office of Consumer Affairs and Business Regulation ;1t 1 10 Park Plaza-Suite 51'70 ' ��F iTJ ,// Expiration: 6/15/2012 Private Corporation Boston,MA 02116 WENZEL FRAMING,INC. Mark Wenzel 45 Whidah Way <• r�., >�/eG��...� �1f �C 2, 1 +� :�'lrlil ' Centerville,MA 02632 lhidcrsccrchu'y Not valid without signnturo a �.•B. C $ .... ' • b ° __ • .b REMOVE EXIST,REM PATCH W NMATER IDAOO R I ✓ Tr _ � EMOTING OTCNEN TO MATCH EMOTING EMSTINO EXISTING RCMEN CONC.STEP To_/ KITCHEN .a , _ . r REMAIN . FASTNG GARAGE4 0 FASTING GARAGE. C V . n. FAMILY ROm i' _ WaWwuo ro FASTING UVING FASIINO LIVING ROOM OLMNO pEMOVE EASf.OVERNEAD ROOM ROOM . - OOOq 6 PATCH N'ITN MATERIALS TO MATCH EXISTING EXISTING GARAGE PLAN DEMOLITION PLAN NEW FLOOR PLAN SCALE 1/4"=1'•0° SCALE 1/4°=1'-0" SCALE 1/4°=1'-0° OENNIB RN1i,MA WMY roaMO[u 4", 24'A' B.a• 14.Y r[rbW(YT.M°G� rvu 80B.1TS/1W�mi.N,vbnlPi®vWon.nvl FRONT ELEVATION' aoNCl3AM SWAY REAR ELEVATION SIDE ELEVATION CPNTEREVILLE,MA SCALE 1/4"=1'-0° SCALE 1/4'-1'-0° SCALE 1/4°=1'-0° BUILDER: - . .' WENZEL FRAMING IMPORTANT NEWPPLAN•LEATIONS PLAN SMOKE DETECTORS REVIEWED NEW PLAN•0.Lfi"VA71DNI ANY CONSTRUCTION THAT INCREASES LIVING SPACE auLYa.2a„A-1 BEYOND 1200 SO. FT. P —U4°TO• VAPIPOLLBUILDINUUPI. DATE IN51ALLATION OF ADDITIONAL SMOKE DETECTORS NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS—THE ELECTRICAL FIRE DEPARTMENT DATE PERMIT DOES NOT SATISFY THIS REQUIREMENT. BOTH SIGNATURES ARE REQUIRED FOR PERMITTING w REMOVE COST.REM DOOR w'nX"—"•� PASTING KITCHEN d PATCH WITH MATERIALS TO MATCH EXISTING EXISTING KITCHEN.. D - ( ✓ EASTRIO WTCHEN REMAIN _ EMAI STEPTO— . N _ 1 'p FASTING GARAGE ~ 4 0 EXISTING GARAGE Q'. FAMILY ROOM IP 1 •� � N � • .� k N k �LN6 nlolf , nimia.wBn ' x G T b_ MiwoBiGw EXISTING LYING. FASTING LIWNO MOSTINGLMNG REMOVE EXIST.OVERHEAD ROOM - ROOM ROOM DOOR 8 PATCH WITH MATEWALS TO MATCH EXISTING GARAGE PLAN _ DEMOLITION PLAN NEW FLOOR PLAN s SCALE 1/4"=1'-O° SCALE 1/4'=1'•O° SCALE 1/4 r.rwpmma;m .I. to • _ .. b� )J'� �' ® DLSDH OE9ON A99oCNTEB umXerm - - .l,,,a .rBN•awn xmlw. OBNNIB PORT.NA BBMB ze'a QP ..c'w`""`wweAm w`°a i.•'.n` Nn.ne+wo ww.mo�mw�®..�na 1•••P m. ° RONCHEM PESIDENCE ` 343 AMES WAY REAR ELEVATION ' SIDE ELEVATION ^FRONT ELEVATION' _ _ SCALE 1/4"=1 0° /4 SCALE 1/4'=1'•O' cPxreRVlue,MA SCALE , _ BUILDER: 1 ° 1'•O° - - WENZEL FRAMING I - EXIST.PLAN•DEMOUTION PLAN- `NEW PLAN•ELEVATIONS a.M D O. • _ _ .. •"'IB4•.°I.Q. OUSTING ROOF ASSEMBLY _ - p • NEW R-38 INSUL. - - — — PROPER VENT& 4 v o • WIND BLOCKING PROVIDE SOFFIT VENTS IF NONE _ I uauA.aa+ NEW 1/2'GYP.BD.CIELING ON 1X3 @ 24"C.C. - OUST.STUD WALLS W/NEW R-11 2,'-S INSUL.&1/2"GYP.SO. m 31h• .. N AN 31N EAS0 WCHEN NEW 2X10 FLOOR SYSTEM W/ '�$` BRIDGING MID SPAN&3/4"PLY WD.GLUED&SCREWED-R-18 ' ,-.-�.•-,:..•�-.-+�.,... INSUL MIN. § ' Q FRAMING SECTION ROOK SCALE 3/8' rALLOWNE, P OF FLOOR JOISTS TO 4.0" W RN.FLOORTOBE W/ XISTING HOUSE FLOOR FLOOR FRAMING PLAN EXIST.STUD WALLS SCALE 1/4"=1'•0" 13'-8" T31h' NEW FLOOR ASSEMBLYSEE FLOOR FRAMING PLAN MOST PIAS.PWSH - 2X10 LEDGER BOARDS . - r ® g8pn0eSIRl ABSOEIAT89 OENNIS PONT,YA E,039 - . poFnMI00 xuH dgtltllp��iM.nd RUNCHETTI RESIDENCE 343 AMES WAY CENTERV[LE,MA BUILDER: W ENZEL FRAMING FRAMING SECTION-FLOOR FRAME cl) FLOOR FRAME DETAIL DETAIL.FLOOR FRAMING PLAN SCALE 3/6'=1'-0" • - ^as noTED ®Boise Cascade Double 1-3/4" x 9-1/2" VSA-LAM@ 2.0 3100 SP Floor Beam\F1301 BC CALCO 3.0 Design Report- US 1 span No cantilever 12 slope Thursday, July 28, 2011 Build 517 ' 'r File Name: M Wenzel—Ames Wy Job Name: Ronchetti `` Description: FB01 Address: 343 Ames Way Specifier: Joe Madera City, State, Zip: Centerville, MA Designer: Customer: Mark Wenzel Company: Shepley Wood Products, Inc. Code reports: ESR-1040 Misc: ` 14-00-00 B0, 3-1/2" 61,3-1/2" ILL 1,680 Ibs LL 1,680 Ibs DL 906 Ibs DL 906 Ibs Total Horizontal Product Length=14-00-00 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% 1 Standard Load Unf.Area (psf) L 00-00-00 14-00-00 20 10 12-00-00 Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment 8,467 ft-Ibs 60.7% 100% 1 1 - Internal Completeness and accuracy of input must End Shear 2,185 Ibs 34.6% 100% 1 1 - Left be verified by anyone who would rely on Total Load Defl. U291 (0.559") 82.5% 1 1 output as evidence of suitability for Live Load Defl. U448 0.363" particular application.Output here based ( ) 80.4% 1� on building code-accepted design Max Defl. 0.559" 55.9% 1 properties and analysis methods. Span/Depth 17.1 . n/a - 1 Installation of BOISE engineered wood products.must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide or ask questions,please call BO Post 3-1/2"x 3-1/2" 2,586 Ibs n/a 28.1% Unspecified (800)232-0788 before installation. B1 Post 3-1/2"x 3-1/2" 2,586 Ibs n/a 28.1% Unspecified BC CALCO,BC FRAMER®,AJST^", ALLJOISTO,BC RIM BOARD TM BCIO, Notes BOISE GLULAMT^^ SIMPLE FRAMING Design meets Code minimum (U240)Total load deflection criteria. SYSTEM@,VERSA-LAM@,VERSA-RIM Design meets Code minimum (U360) Live load deflection criteria. PLUS@,VERSA-RIM@, Design meets arbitrary(1") Maximum load deflection criteria. VERSA-STRAND@,VERSA-STUD@ are Simpson Strong-Tie,Tie, Inc. trademarks of Boise Cascade Wood Fastener Manufacturer: Sim p g- Products L.L.C. Connection Diagram b d a • '(-• • - c a minirnum = 1-1/2%=6-1/2" b minimum-4" d = 12" e minimum = 1" Install Screws with screw heads in the loaded ply. Member has no side loads.. Connectors are: SDW22338 Page 1 of'1 #� Town of Bath-stable BARNSTABLE. ` Regulatory Services ices Y MASS. 039. Building Division prFO MPS>• 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection rNy Location 3 y3 1-M C S L J AY Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: 2" CLFARM)CIE PEEW-b J�Ra wD Cl-�MMPEY F C L G a �"iS vr(�SPA r3 (BEArv, NEF-DEf� PA-�lb5PA/�J b�,3 s A� PE6Er)eNT)oNS L-t03q Please call: 508-862-4038,for re-inspection. Inspected by �Llt)AI Ah -- 1 I! k Date 7 � 111� V I F. t s �Y► x�,,, Town of Barnstable *permit# 6 6C 10 Expires 6'011ths front issue date Regulatory Services FrERMIT 1639,, ,0� Thomas F. Geiler, Director AtfO ll Building Division OF BARNSTABLF_ Tom Perry, CBO, Building Commissioner "! vv� 200 Main Street, Hyannis, MA 02601 www.town.barnstab le.ma.us Office: 508-86274038 Fax: 508-790-623 0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number t A 0 , ova g, Property Address C�� residential Value of Work �-� 0o _ Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address L'� 2 Contractor's Name_ Telephone Number SGP�) �L2j_Snn Home Improvement Contractor License#(if applicable) JCS Construction Supervisor's License#(if applicable) ®Workman's Compensation Insurance Ch11 am I am a sole proprietor • ❑ lam the Homeowner ❑ I have Worker's Compensation Insurance, Insurance Company Name 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 -VO w0i O �)OQ evje_ kwAr% k\ Re-roof(not stripping. Going over I existing layers of rood ❑ Re-side ❑ Replacement Windows. U-Value (maximum .44) *Where required`. Issuance of this permit doers nonexempt compliance with other town department regulations,i.e..Historic,Conservation,etc.' ***Note: Property Owner must sig roperty Owner Letter of Permission. e [mp m n SIGNATURE•• cot rs Lic se& Construct Supervisors License is required. Q:\WPFILES\FORMS\Express\EXPRESSPERMIT.DOC Revise06O4O9 r s,y =o try Town of Barnstable ,. .� Regulatory Services swx»srARM r rAsa $, Thomas F.Geller,Director 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 If Using ABuilder as Owner of the subject property hereby authorize k C�ryx-t_ 1 e � to act on my behalf, in all matters relative to work authorized by!�his building permit application for: (Address of Job) 0 S' er Ilate Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FO R.M S:O VJNERPEP M IS S ION Town of BarnstableTHME ^ w Regulatory Services t HARlvcr.xr F. Thomas F. Geiler,Director t�snss . � 163P. Building Division PrED�A Tom Pe 'rry,Building Commissioner Main=Street;Hyannis,MA 02601 _._..__..._. . . www.town.barnstable-ma.us Office: 508-862-4038 /, Fax: 790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: -7 (0 �Q�. S F . UXt k e S k< C� cityttown state zip code The current exemption for"homeowners"was extended to includ owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does t possess a license,provided that the owner acts as supervisor. DEFINITION OF H OWNER Person(s)who owns a parcel of land on which he/she resides r intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached siructY es accessory to such use and/or farm strictures. A person who constructs more than one home in a two-year pet.'.od shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a fo acceptable to the Building Official,that he/she shall be res onsible for all such work performed under the buildin ermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for ompliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned."homeowner"certifies that.he/she unde stands the.Town of Barnstable•Buildiugbepartment minimum inspection procedures and requirements and t he/she will comply with said procedures and requirements. Signatiirc of Homeowner Approval of Building Official Note: Three-family dwellings con ' ' g 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Cons ction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeo performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -licmsing of ction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall ad as sor." Many homeowners who use this emption are unaware that they are assuming the responsibilities of a supervisor(sec Appendix Q, Rules&Regulations for Licensing Cons ction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed ns. 1n this case,our Board cannot proceed against the unlicensed pMori as it would with a licensed Supervisor. The homeownm acting as upe visor is ultimately responsib]e. To ensure that the homeo a is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that hds 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 d and adopt such a form/certification.for use in your community. Q:forms:homcexempt 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/Organization/Individual): Address: City/State/Zip: 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 ployees(full and/or part-.time).* have hired the sub-contractors 7- ❑6. ❑New construction 2. I am a sole proprietor or partner listed on the attached sheet. 7 Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY• $ 9. ❑Building addition [No workers'-comp. insurance comp. insurance. 10. Electrical repairs or additions required.]. 5. ❑ We are a corporation and its ❑ P 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions right of exemption per MGL myself o workers coP P Y � mP• 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 anew affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the 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 MA 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 cerWfy er the pai d pe of perjury that the information provided above is true and correct Si a e Date: ( f 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#: Information and Instructions fi 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 of 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 e ear,need only submit one affidavit indicating current that must submit multiple permit/license applications in any given y y g 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 C6mmonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-72 T-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia l Board of Building Regutatiofis and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards UV Registration:,, 138653 One Ashburton Place Rm 1301 Expiration:..5L'1/2011 Tr# 283921 Boston,Ma.02108 1Ty0e: Private Corporation COMPASS REALTY DEVELOPMENT CORP MICHAEL DEDECKO 25 CARLETON DR. Not valid without signature MASHPEE,MA 02649 Administrator .�• t s Y� �� T f t "d `?"` Nv � 11504 �Cor�as. , ky9a'ICIFiI'I�ni : rit+�M� { yLi� hrQ El;., v F 2 ,. f.�,� •�!..r a ,d �. ^*^"*�s^wr^t' .� .uay� ,C'r-ks�,C �..'. r TOWN OF BARNSTABLE Permit No. _--------_--------- i• Building Inspector AMSTAX Cash OCCUPANCY PERMIT Bond ----___-------_A` % No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to T. P• Breen Co., 1n, Address G12 Lake chore LT.s mars tons Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. ...................................................... 19..._.__ ............................................................................................................._ Building Inspector Assessor's map'and lot number ........•..1... .. •- n OWN fT ,. Sewage Permit number .... ......y.......................................::..... RQ N�osc+4- H E NME AW 4 QyOFTHE tp�y TOWN OF RARNSTIM �q Z EARNSTAl1LS, i r °mooAGL pYa�� BVILDIHG µhHSPECTOR APPLICATION .FOR PERMIT TO ...` .. .••. TYPEOF CONSTRUCTION ................... . ............... ......................./......................................... . ........... . ......................19. TO THE INSPECTOR OF BUILDINGS: The undersign appli r a permit according the followinginformation: 0(,+3 / 2 pp�� .... ................................................................... Location ............ ........./. ...... ................. .. ProposedUse �..� .. .....�.��4.................. .................................... .......................................................... ZoningDistrict ....... .................................. .... ,.... ................Fire District ............. .......... ............................. . .......Address ..,244...................................... ... Name of Owner .. ... ...... .. .... ........................... ,. Nameof Builder ........ ..........................Address .................................................................................... Name of Architect ......Address Number of Rooms .................. .......................................Foundation .........1..40.... ..... ..................................... c GCJ Cl.................... ..t:. ...................Roofing ....... .. ...... ......... ....�............................................ Exterior ............. .... . (� Floors ...............................................Interior ....... ...... .............d ........................................... r- ing .../, ..f 1!. ...............................................................:Plumbing ...........Z. 'e. ........................................... -- d Fireplace ........ . .....................................................................Approximate Cost .. .. .................. Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area ......�.7.o .Sc............ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Q s I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... A-s-.4:. .... i...... ...... ....................... ......... MEEMNENFT--,!� J. P. Breen Co. , Inc. A=170-22$ f = r � � I No 213.41....: Permit for ....single...family... ...dwelling.........................:............................... *: Lpcation .1at-429........343•Arn".•Way.'.............. ..............Cen te=Ule....................... _ r Owner .....J.,P...Breen.Co..•$..Inc................... Type of Construction - - ` � Y � ................................................................................ Plot ............................ Lot ................................ I Y Permit Granted ...........June..4 June-.4....... Date of Inspection ..19 Date Completed ... .... .....................19 + 'PERMIT REFUSED ...........................:............................. :... 19 t 1 .. ................................................. i Ap ..................................... 19 ` i . am 44 AA ..................................................... �� " 71. ev Y, ............... a g 0 0 14. % 1Q W. 77 V /Igor, 7' 0 7L 10, 71 Q 40 cam. u -W C-1 71/c 0-- 7�e7 0 717 ?7 X .............. ilk or OF Al,,_ FRANK FRANK � CONERY ONERY NC� 6573 No. 6232 14.m a 6 WA-"V- /STE IST MAL t sup A\ PLAN of LAND I CERTIFY THAT THIS PLAN SHOWS VASS. THE ACTUAL LOCATION OF THE vi OWNED BY STRUCTURE ON THE LAND AND THAT IT CONFORMS WITH THE BY-LAWS OF THE TOWN FRANK CONERY 5 TRENTON ST. HYANNIS. MASS. 02601 REGISTERED WNGIMgp & LAND SURVEYOR SCALE I IN 20 FT.