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Town of Barnstable . R,ECEiPT
" 200 Main Street, Hyannis MA 02601 508-862-4038
Application for Building Permit* ° :
Application No: TB-19-1897 Date Recieved: 6/7/2019Ln' p
-n
Job Location: 225 ANSEL HOWLAND ROAD,CENTERVILLE 0
O p
Permit For: Building-Insulation-Residential
Contractor's Name: WILLIAM J MCCLUSKEY State Lic. No: CSSL- 02776 :0
Address: West Yarmouth, MA 02673 Applicant Phone:. (508)3 8-0398
(Home)Owner's Name: NEARY,PAUL M Phone: (508)209-7426
(Home)Owner's Address: 225 ANSEL HOWLAND ROAD, CENTERVILLE,MA 02632
Work Description: Add R-33 cellulose,and R-10 rigid insulation to the attic.Air seal the attic plane with expanding foam.
General weatherization.
Total Value Of Work To Be Performed: $2,200.00
Structure Size: 0.00 0.00 0.00
Width Depth Total Area
I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before
he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568).
I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to
accept coverage.
I hereby certify that I am the owner of the property which is the subject of this-application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a.permit is issued,it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained within is true and accurate to the best of my knowledge and belief.
All permits approved are subject to inspections performed.by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: William McCluskey 6/7/2019 (508)398-0398
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost : $2,200.00 Date Paid Amount Paid i ` Check,#or CC# Pay Type
Total Permit-Fee: $85.00 6n12019 $35.00 1 XXXX-XXXX-XXXX- Credit Card
0299 _
Total Permit Fee Paid: $85.00
6/7/2019 $50.00 X3CCC-X300{-X}OIX- Credit Card
0299
r .
Cape Save Inc.
7-1) Huntington Avenue
South Yarmouth, MA 02664
Tel: 508-39870398 Fax: 508-398-0399
7/8/19
Brian Florence CBO
Town of Barnstable BUILDING DEPT.
Building Division
200 Main St. AUG 0,9 2019
Hyannis,MA 02601
TOWN OF SARNSTABLE
RE:'Insulation Permit 19-1897
Dear Mr.Florence:
This affidavit is to certify that all work completed for,225 Ansel Howland-Road;Centerville)has
been inspected by a third party Certified Building Performance Institute(BPI)Inspector
All work performed meets or exceeds Federal and State Requirements.
Sincerely,
William McCluskey
BIKE TO�ti Town of Barnstable *Permit#
p^ Expires 6 months from issue date
*` ' T'
BAmir im . Regulatory Services .
Fee
1ss'1639. 0 Thomas F.Geller,Director
p,�'
Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601 �� e 2005
.Office: 508-862403 8
Fax: 508-790-6230
TOWN OF BARNSTASLE
.EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 1-7 1
Property Address cS1 6vv4
[Residential Value of Work ---'C160 a Minimum fee of$25.00 for work under$6000.00 '
Owner's Name&Address
Contractor's Name elephone Number
Home Improvement Contractor License#(if applicable) /��K"3.6 =
Construction Supervisor's License#(if applicable) }
E§Workman's Compensation Insurance
Check one: ;
❑ I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp. Policy# Z yX 6 14 /a '
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 e..jz
❑Re-roof(not stripping.- Going over existing layers of roof) n
❑ Re-side
❑ Replacement Windows.YU-Value' (maximum.44)
*Where required: Issuance of This permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
f ***Note: . roperty Owner must sign Property Owner Letter of Permission.
me I rov Contractors License is required.
Signature
Q:Forms:expmtrg
Revise063004 +
Fraser :Construction
Roofing & Siding Specialists-,
Payable immediately upon completion
NO MONEY DOWN - NO Payment at the start or part way thru
Payments accepted are:
CASH - CHECK- MASTERCARD -VISA-AMERICAN EXPRESS
Any payments not made within_ 30 days of completion will be charged 1 ''/z%for every 30 days
the payment is late.
Possible Extra -After the shingles are removed from the roof, we will life one
sheet of plywood to make sure that the insulation be not up against the
plywood sheathing so that ventilation cannot occur from the eaves to the ridge.
If it is, ventilation panels will be installed by; removing the plywood sheathing,
installing the panels, turning the plywood over and then re-installing the
plywood. If needed,,this would be charged for as an extra at the rate of$4.00
per panel including Materials & Labor. There are 6 Panels per sheet of plywood.
Possible Extra -Any rotted or otherwise deteriorated trim boards, plywood
sheathing, lead flashing, or other carpentry needing replacement will be done
and charged for as an extra at the rate of$40.00 per hour, plus materials, plus
20% overhead mark-up on total extras.
FRASER CONSTRUCTION Warranties the shingles and labor for 10 years.
FRASER CONSTRUCTION Warranties the shingles.against Blow-Offs.for 10 years.
CERTAINTEED Warranties the shingles and labor 100% for the first 5 years,
and then on a pro rated basis for 30 years total if the shingles become defective.
CERTAINTEED Warranties the shingles to be ALGAE resistant for a full 10
years.
Any deviation or alteration from above specification will be executed upon
written orders and will become an extra charge over and above the estimate. All
agreements contingent upon strikes, accidents or delays are beyond our
control. Owner should carry fire, tornado and other necessary insurance upon
the above work. We, if not accepted within thirty-days may withdraw this
proposal.
FRASER CONSTRUCTION: Carries Workman's Compensation and Public'
Liability Insurance on the above work. ,
DATE OF ACCEPTANCE:
SUBMITTED BY:
eow er Fraser ruction.
The Commonwealth of Massachusetts
T� Department of Industrial Accidents
=_ Office of investigations
600 Washington Street, e Floor
Boston,Mass. 02111
Workers'Com ensation Insurance Affidavit:Buildin lumbin lectrical Contractors
f"
name ✓l ft�.Q,L.� L
address: —7/ �T-- ids
city G`'t—c com state: �,��j� zip'• o �ohone# ,
work site location(full address)
❑ ]am a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel
I am a sole proprietor and have no one working in any capacity. ❑Building Addition
'"`u.�,,.,,^^ g'. - .:aE;-.•.`k,' �3" • s"y" ,` . '� :1'.t3:x lt.*'., X"<3f'e`a'it.:,}`:d:'_.':n',:R.;t,'.'.ti`�`'•.'��..T.°�2'.t�.,.� -K _ "'!t' a•.:�''..`as t:
I am an employer providing workers'compensation for my employees working on this job.
company name,
address:
city.. phone#
insurance co. Vim`` oli # h �7 L
❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have
the following workers' compensation polices:
colnuany name: _
address:
phone M
insurance co. oli #
company name:
address:
city phone#•
insurance co. 0110# _
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me, I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereby ce under the pat s e ' that the information provided above is true and correct.
Signature Date
Print-name { ��`�'`�` Phone# '
official use only �no, this area to be completed by city or town official
city or town: permittlicense# ❑Building Department
❑Licensing Board
❑check if immediate response is required" ❑Selectmen's Office
❑Health Department
contact person: phone#; ❑Other
(revised sepi.2003)
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law",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 section 25 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,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.
moil
Applicants
Please fill in the workers' compensation affidavit completely,.by checking the box that applies to your situation. Please
supply company name, address and phone numbers along with a certificate of insurance as all affidavits 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..
City or Towns
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. The affidavits maybe returned to
the Department by mail or FAX unless other arrangements have been.made.
The Office of Investigations would like to thank you in advance for you 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,7`s Floor
Boston,Ma. 02111
fax#: (617)727-7749
phone#: (617)7274900 ext. 406
A
✓hie �o7xma�zuiea� a�✓�aaoac6u�aelld + - -
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IM.11�OVEMENT CONTRACTOR befoi i the expiration date. If found return to: '
Boaj%j of Building Regulations and Standards
Registrar m 912536 One Ashburton Place Rm 1301
2007
t, - - . •
Boston,Ma.02108
FRASER CONS
DEAN FRASER
71 TARRAGON CIR
COTUIT, MA 02635 Administrator Not valid without signature
s •
�„` '• TOWN OF BARNSTABLE Permit No. _-----------2-4fi--------------
i sWn.� Building Inspector cash H
OCCUPANCY PERMIT Bond
?s;ued to Alan R, Skin Address
?7'; '�.n5el npd, ( enYPnT' I J P-
Wiring Inspector ti= Inspection date
Plumbing Inspector Inspection date
Gas Inspector Inspection date
Engineering Department Inspection date
Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
......................................................1 19.......... ..................................................a............................................................
Buildinn Inspector
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NoT AG- vyc•n-ca pGTc:.c°.MINE LET' 1-INc�� APP1.•Ir� ALA0 S.: SMALL roc ,
� �assessor's map and lot' number ... .... .. o*T E_r01`
Sewage :Permit number ..... ' .� 1.. ..' d�P ♦�
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.M r,gy x B�AUST A U
tHouse number .... ..: � p A�L MUST
.. b9� Ea tipP •�TOWN eO
TOP
BUIL-�DI- INS PEC"T0R
APPLICATION FOR. PERMIT TO .. .
1 T1fPE-'OF CONSTRUCTION :..� t,a ^.t' .�. ........ ... ................................................
s � 7 g f`
. .. .... ...... ..19........
TO'`THE INSPECTOR"OF 'BUILDINGS''wa y'3 k'
The undersigned hereby applies for aa .permit according jo the following intotmatiaW, '3 ,
Location .... .... .........................................................
?-�.... t r
...... .... .. ...............
..... ..:....
Proposed Use .
Zoning District .................................................. Fire District �L:. .... ................
..G . J ... Address ........ . ��....Name of Owner` ^�. .... ..... .. -",�.,1../. =-l!�L�� .....
Name- of Builder. .........
' E. ........................... Address ...:..........
i
Name of Architect ..... ................ ........... . .. ... ..Address ............. .: .. . .....................................................
......... ............. ......
Number of Rooms ..... L.:....... Foundation ......1 ! �%` `' .-".
Exterior �.............. . . ... Roofing ....
j -
..... �`'8 . jC/ e���r
Floors .............................................................:Interior ..... .q..............................
J "lieafing/ . «... ." Plumbing • �' '(' f
Fireplace .�%f`?� �Y �.. ......... .... ..... ..Approximate Cost ...........' f ll r
y'
Defini#ive Plan Approved by 'Planning Board _=____ �=__________-19_,____:. Area Z
��.��............ ...
Diagram of Lot and Building with Dimensions Fee
SUBJECT, TO-APPROVAL OF BOARD OF HEALTH' 000
r
o n
a , , -
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of rnstable regarding a above
construction.
Nam .... .....
F
',SMALL, ALAN E. t L
t �vr24759'� 1 i Stor '
i No ..... Permit for .. .. X....:........
Single Fami1 Dwelling.•_._•.....
f ....
t Location ....Lot•.#2.f...2.25..Ansel. Howland 'Rd. '
Centerville F
...............................................................
Owner Alan 'E Small + .
Type:of Construction. Frame..........................
.. .................................. ....
Plot ............. ............. Lot. .......... *' -,,...........
Permit Granted .,January, 2 7, 19 83 J ;
Date of Inspection ....................................19 ;
Date Complet d1� Ae3..........19 I :.
Assessor's map.and plot :number ...
NE
Sewage Permit number ....... ......... .............. �. r!s'� °,►
DAUSTAX
House number ...' ........ ................. ..`.'.. ... .. .......... VMAN s
14 39•
�a esY a.
r
TOWN .. OF . BARNSTABLE
t
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ... c ................. ......... ......... . ...... ........ ................
l� ;�
TYPE OF CONSTRUCTION ...... ....... :. ..,..... ..................:........................ :......................................
............................................. . _
TO THE INSPECTOR OF BUILDINGS: r'
The undersigned hereby applies for a permit according .to the following information:
f
! l f ° r� -7
` Location ....` :. .. .....�' ' � ' `�'r.... ' ...... . 71 .... ... .. ...... .
Proposed Use ........................... . ..........................
Zoning District ...Fire District ... .........................
0
Name of Owner .. ............................................c� 2•r ............
i
.. .............Address ........( ......f:�r.:� ��.: :. /�C � �.
Nameof Builder' ............... ...........................Address ....................................,......................... ...................
Nameof Architect .................... .................... ................Address ......... .. ...:.............. ........... ............ ......
Number of Rooms ......... .................. ......... ................Foundation ... r.. + .-t..-.-. ........ ......... ................
s.h. �i
Exterior ........ ...... ..................................... .............Roofing ........ , ...... , ..............................................................
Floors ....... Interior ............. ........... . ..............................
Heating ..........:...... ......... ..... ......Plumbing ............,... .........' .
Fireplace ... a.�.('44 �� ... ..Approximate. Cost ... ,
.... .. ..
1-i
Definitive Plan Approved by Planning Board -----------_____—-----------19_______ Area �:. '
Diagram of Lot and Building with Dimensions Fee '
SUBJECT TO APPROVAL OF BOARD OF HEALTH
- r
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.'
Name:............................................... _ F............................
.
S8�\LD� AL�N E. A=171-241
347S��
Permit for ..l�2-.. .............
Sio�l Family Dwell '
_.-.--- ��---''--- .......................--~'.............
Location ^-' -AllP.Q_I..]�D.W.land
................q!mt!mxUl��---------.---
Owner .^.. .............................
Type of Construction -F.rame.--------,.
-
-^`~—^^'~^~~^'~^-^-'----^--'-^-'--'-^''
�
Plot ............................ Lot ................................
Permit Granted - ...3.7.x-.-lA 83 '
Date of Inspection .................................... A
Date Completed ------.----.---l9
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