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0096 AUTUMN DRIVE
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B-18-1248 Applicant Name: Carl Rebello - Approvals Date Issued: 05/18/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 11/18/2018 Foundation: Location: .96 AUTUMN DRIVE,CENTERVILLE Map/Lot 168 055 Zoning District: RC Sheathing: Owner on Record: DAVERN,JANE A GntractoraN e Carl J Rebello Framing: 1 Address: 96 AUTUMN DR Contractor License GCS 084358 2 CENTERVILLE, MA 02632 �� J Chimney: Est' Pro ect Cost: $5 901.00 Description: Insulation,Air Sealing&Door Weatherstripping Permit Fee: $85.00 g Insulation: Project Review Req: signed installers certificate required to cIbsegP h11t Fee Paid $85.00 \ Da'te 5/18/2018 Final Plumbing/Gas T _. Rough Plumbing: - --- Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work auth6tize by this permit is commenced within six min, afte uIssuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for'which this permit has been granted. All construction,alterations and changes of use of any building and structures shall;be in compliance with the local zomng'by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or oa' and shall be maintained open for public inspec'Jpn for the entire duration of the work until the completion of the same. Electrical ;H Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are prov ded on this permit , Minimum of Five Call Inspections Required for All Construction Work:; Rough: 1.Foundation or Footing . g 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 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 *Permit# Expires 6 monflis from issue date Regulatory Services Fee C;)S ° Thomas F.Geiler,Director ff Building Division Tom Perry,CBO, Building Commissioner s W/V of 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-40T 18tE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 1�' /0 sr- Property Address q C 4 y`>u pii N 1,.2I UC t=�"1'Crty rLt-A Eg'Kesidential Value of Work �Aa�000, 00 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �� 7y�aZa: AA 2 Contractor's Name I. M G`vv\;�5 A. 1—a+.sc Telephone Number ��1-74'q�� 6 o eF Home Improvement Contractor License#(if applicable) 4 Construction Supervisor's License#(if applicable) ` ❑Workman's Compensation Insurance . Check one: am a sole proprietor ❑ I am 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 17 Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ®rReplacemen indoor d ois sliders. U-Value t 3 (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.' ***Note: roperty Owner must sign Iroperty Owner Letter of Permission. A copy of th ome71in ,ovement Contractors License is required. SIGNATURE: r Q:Forms:expmgg Revise061306 4 �ie r�6ry�ry, u�eaC o�✓�aaacu/uaelta . Board of Building Regulations and Standards License or.registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Standards S Board of Building Regulations and ; Registration:, 142393 One Ashburton Place Rm 1301 • Expiration 4/1/2010 Tr# 264734 Boston,Ma:02108 Type inidividual _. `Fit 3 f :�4 /1•. THOMAS A LONG^. s{ l THOMAS LONG 166 KNOTTY PINE LANE --- ' Not valid without signature . CENTERVILLE,MA 02632 Administrator. I 1 1 £ elk �0979AY1(YI7.11JP 6I /,� / ,. �3oard of Building Regulations and Standards -l l y Construction Supervisor License License: CS 86040 Birthdate: 8/29/1960 ��Expiration-_g/29/2009 Tr# 811 �- I43n ` �, Restriction 00;{{))` A ja �i THO^,A AS A LONG i� 166 KNOTTY PINE LANE ' — �J I CENTERVILLE,MA 02632 Commissioner ; 1 f, LN The Commonwealth of Massachusetts . Department of IndustrialAecidents 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): . 'F�40MO S A-- .Ld+jft Address: [U(o V1,1JE.17"t PcuIZ L*-C- City/State/Zip: CE-Kv&,4"Ljrt , M� 'CZ0 z Phone.#: -7-2 4—8 3 E—ec o•�tr 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 * have hired the stab-contractors 6• ❑New construction . loyees(full and/or part-time). . 2. I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling s and have no employees These sub-contractors have �P8. ❑Demolition working for me in any capacity. employees and have workers' insurance,#' 9• []Building addition [No workers' comp,insurance comp. required.] 5.'E j We are a corporation and its 10.❑Electrical repairs or additions . •3.❑ I am ahomeowner doing all work . officers have exercised their Il.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MG!, 12.❑Roof repairs insurance required.] t C. 152, §1(4),and we have no ` employees, [No' workers' . 13,— Other bd I4,0 +1 M�llcs7ce,..,d' 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. IContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. ram an employer that is providing workers'compensation insurance far my employees. Below lsfhe'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 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby .ruder the pains•and penalties of perjury that the information provided above is true and correct: Signature. G,� 1.�. Date: tc 11 /01 Phone#: 1-7 4 t G •-"41- — Official use only. Do not write in this area,tb 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 CIerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: ZHE Town of Barnstable. t Regulatory Services as MS. nSs. Thomas F.Geiler,Director � � Building Division AlFD��A Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 "'w-town.b arnstable.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 authonze —7—HO MA to act on my behalf, in all matters relative to work authorized by this building permit application for: . g� L)I-uV.J 'O(t_ C- IW-C (Address of Job) S' ature of er Date Print Name 3 QTOMMS:OWNERPERMIS SION IN E TOWN OF BARNSTABLE BULDING INSPECTOR TO THE, INSPECTOR OF BUILDINGS: The uncle'rsigned hereby applies-for a-"permit acc.orcli�g rb-the foillowing information: Proposed Use ... It7..................... Name of Owner e44��............Address ap.. ...i4w.. 44.). Name of Architect ..---------------------A66res ---------------------'----''^ — Number of Rooms -.�..--------. ----Foun6otion ................................................. Exierio, ������������������. -,--'Roofing � ......... Floors ...--.--------------------|nto,io, .............. Heating --------------------.P|umbing - ................ , Rnep|ooe _---------------------.App,ox|moteCox - ..dy�?� `.__..-. /O�s Difinidva P|on �A`l5orove6 by Planning 800nj --------------------------------19--------, . . Diagram 'of io*ron6 Building with Dimensions ^^-�-e�' ILL U) \N / � ` ' UJI LU I hereby agree to conform to all the Rules and Regulations of the -----------------'—^' Christopher, Christopher 14846 Permit for one story, No ................. .................................... single family dwelling 7-S .................................. .............. Location I Autumn Drive.............................. .............. ........ . Centerville ............................................................................... Owner ..........Christopher. ..Chr.i.stop.her..... A4 Aj ............. ...... . ........ ...... Type of Construction .........frame....................... .................................... ........................................... Plot ............................ Lot ................................ March 17 Permit Granted ........................................19 72 Date of Inspection ..e...............................4W 171L "ft. Date Completed ....Vm IA ..........19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................. ............................................................................... ....................................................... .................. Approved .................................................. 19 ............... ............................................................................... ............... ................... ......... .................................................