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0215 BAY LANE
t f ��ev� S'� � vey-�-n _ Town of Barnstable Building _ ems , � • • aN�rnPost This Card So That it is Visible From the Street Approved Plans Must be°Retained on Job and this Card Must'be Kept > Posted Until Final Inspection as Been Made. F. �� �� 34 s` Where,. ....,...rtifi.- ..f, _. � � M 6 Where a�Certificate°of.Occupancy-is RequiGed,such Bu,il�lmg sh�l1 Not be Occupied until a Final Inspection'has b"een made. Permit No. B-19-3057 Applicant Name: Dean Fraser Approvals Date Issued: 09/17/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 03/171/2020 Foundation: Location: 215 BAY LANE,CENTERVILLE Map/Lot: 186-013 Zoning District: RD-1 Sheathing: Owner on Record: ;KEVLES, DANIEL J&BETTYANN ( Contractor Narre ' Fraser Construction Company,Inc. Framing: 1. Address: 11 FIFTH AVENUE,APT 11U ' _ Contractor License: 194.�747 2 .:>,. NEW YORK, NY 10003 s Est Project Cost: $ 15,995.00 Chimney : Description: Re roofing 33 squares of the home Permit Fee: $81.57 I a Insulation: Fee Paid.'' $81.57 Project Review Req: Final: Date: 9/17/2019 Plumbing/Gas Rough Plumbing: g \Building Official f Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six=months afterissuance. All work authorized by this permit shall conform to the approved application and thesapproved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be incompliance with the local zon ing by-laws acid 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 mspectionfor the entire duration of the work until the completion of the same. r - Electrical The Certificate of Occupancy will not be issued until all applicable signatures'by the Building and Fire Officials are provided ont hiis permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection g 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). 4— fire Department Building plans are to be available on site i�y�' Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT o�� ALL 96� Town of Barnstable *Permit#' Regulatory Services �e 5a� • RIMMASM ' �"8' Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.batmtable.ma.us Office: 508-862-4038 Fax: 508-790-6230' EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid_ without Red X-Press Imprint Map/parcel Number 1 8 0 .3 Property Address J� C9 me. Ce /— / Ie. Residential Value of Work$A w - 0 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address /L°[ y^t!ilI le-- - w t ( -S`f'�► Ate NQw�ar�C /b 6 a,3 Contractor's Name�Dy I • it ea_✓ .s Telephone Number Home Improvement Contractor License#(if applicable) 2Z �Email: 11 C�MC�Ot) ► �d� � L�J>~1CLgS�A1t%! Construction Supervisor's License#(if applicable) C) (D Qg ❑Workman's Compensation Insurance XPFIE. Check one: r/� ►� aI am a sole proprietor" ❑ I am the Homeowner - ❑ I have Worker's Compensation Insurance '40CT,� - 2�-L.2a13� ` Insurance Company Name p, Workman's Comp.Policy# ,y of BtQ�Ns+ p Copy of Insurance Compliance Certificate mast accompany each permit. TA�G7L Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors. ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. . Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. e ***Note:. Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is, rere,quired SIGNATURE: C-\Users\decolU\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content:Outlook\8R76BDVA\EX2RESS.doc Revised 061313 CO. .Custom Building r � 1 CIe;. Massachusetts 02632-1069 �,; 3 (cell) 508-737-5400 dercom r - v i g. L i crone'; t ^i£ � 7 � � ,y��'' a:. �"'"`�- .>r - ,4�:r3tc°"�SC#�.P_=Szt•?�i� cr�j -+3F r _€ CS-016981 F_1 DOUGLAS fl L� IAA+�SR A, `II.L 222 PINB STf: yf: Ceilllervffle l v I 1»t� r — <: 03/07/2014 -M � ;.A�z' jE.G�`C�s�s. iS �aay'S ,s a a tJfWK#sltS 1 � Mv s � t� 1°xi.� �*' 4a`a's �y�•�C�r5--r''�`sG.ys, fly`��f'`�fyC a�'s',. 4.. �� : �'"..>l' � '�F1Ci3 _ % +° 'IND (� r fwlz 21 mm i � y' , nOWEAS MEA .r. J r-i� � f'f X" *s: Lr eor,-�t oa; Ii €or indivtdnf u5e:on1� �.i Uffic, onsnmcr: `airs .B at` »a on date: If found.return to: t fE►re the eipbafi HOMEMPROVEMEWEONt 4GT{7i pace of Gonssaner.�krs:and Business Regulation t t�egistiation 1Q2227 1 20:1'arb Pima=Suife 5i70 ' Expiration: hf2014 ^. Bostan,_ALA Q21ib = DCft AS L W W7 A� SOUSTOM BUILDING DOUGIAS WILLIAMS` 222 PINE ST. CENTERVILLE,MA 02632 Undersecretary Not valid 9yithont signature Town of Barnstable *Permitpq0130� 96P Regulatory Services �e�6 a ^IIrom ate asp, M"9' Thomas F.GeHer,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ( S (Q 0 t.3 / Property Address J� 36ci ne— 8r / e.. Residential Value of Work$ A #00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address It ev �nn� Vorek `/ � /( ( 6" " Air& . mil% /ld /)P,uJ Xpo a✓ L /G Q U3 Contractor's Name7DV L • I o'Z-►��'l S Telephone Number Home Improvement Contractor License#(if applicable)41 r— I ozzqL Email: '1 omC-,W 1 1.�ri1CL45�.Ne� Construction Supervisor's License#(if applicable) (L ❑Workman's Compensation Insurance Check one: j?NI am a sole proprietor P RRM ❑ I am the Homeowner 6 ❑ I have Worker's Compensation Insurance OCT 2 2013 Insurance Company Name A' Workman's Comp.Policy •'y OF$iQ Copy of Insurance Compliance Certificate must accompany each permit. TA��7®® �, Permit Request(check box) t ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value imum.35)#of windows �p #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections regtured. Separate Electrical&Fire Permits required. *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&Construction Supervisors License is —.- required. SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content Outlook\8R76BDVA\EXPRESS.doc Revised 061313 COWYlfMMMM of mass[il husem DeparftnentqfLmdks&iaIAcdden& Office 00wafigadans 600 Wwhogtm Street Bos&%MA 02111 W V V.M gorldia Wail ers' Compensaf wn Insmmuce.Affiidmatl Bm ders(Contractors/ElectricianMumhers Applicant Information r Please Print 1gobW Name opt 106 distal �lirltv� � •�' Phom A_ �6 . 75--40 (J Are you an employee?Check the appropriate bo= Type of project(r"pired): L El I am a employer with 1 . 4 ❑I an a general contactor and I fx ❑New constradiDa employees(fall and(flrpart-time}.* havehitedthe su aciors 2. I 4am a sole proprietor or partner- listed on the attached sheer 7_ ❑Remodeling and have no employees These sub-contractors have 8_ ❑Demolition employees and have woiioess' working forme is any opacity_ z ,9_ ❑Bni1dmg addition comp-insoranm ' p. [Noaroriorss'comp.insurance 5_❑ We are a corporaticnand its 10-0 Mectzical repairs m additions 3-❑ I am a homeowner doing all work officers Dave crercise d their 11❑Phrmbiag rePsirs or additions myself[No worl=e ooanP_ right ofexemption per MG_ 110 Roofer. insumeerequired]1 c.152,§1(41 andwehaveno 13_❑Other employees-[NG wodo=' comp-insurance require&] *Any appHatdmtdhedmboa#lams-A fMaw the mcfimbdowdmwiag&&va*eeoumpe=afmper¢Saaffl®ardm t SnmeDv mess wbo submit this af$davir mduatiag dLey use doing aiiva k and dice hue outside caatractms amst submit a ww afdavk iarr,astasg svcli ZC0nwwt=Ibxtr,hPrkws home must attadhed au addidenal Sheet dwwkg the name of dw sub- ftacbm sod stale whetrw w=thM effii0Mh=,e emPlvyees- ffthe=b<onmiams have empavfees,fey moat provide their workers'comp policy mmmber I am an emp&3w that is prdWAhZ terorkem,eonrgsnmfign hmrmce for my employees Below is the paucy gated job site information. Insorance Company Name: . Policy#or Self--ins Lie.#_ Expiration Date: Job Site Address_ City/Statetzip: Attach a copy of the workers'compensation policy declaration page(showing the policy um caber and emotion date). Failure to secure coverage as ragwxedunder Section 25A o€MGL c. 152 can lead to the imposition of criminal p wahms of a fine up to S1,500.00 and/or one-ye grim ,as well as civil pis is the form of a STOP WORX ORDER and a fine dreg to$250-00 a day against the violator_ Be advised that a copy of this statement maybe fi xwarded to the Office of Iavesti ptions of the DIA for insurance coverage verification_ I do hereby cetIfy under the pains and penaWes.ofperjury that the information prmrided a e is ?and correct. Dates Phone A.- Official use only. Do not errita in this area,to be comph#ad by city or tmrn gficiaL or Tows: Permit/License# hsning Authority(drele one) L Board of Health 2.Biding Department I Cify/Town Clerk 4_Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 R; K, �► Town of Barnstable. Regulatory Services 'W 'XAM = Thomas F.G-.aler,Director �q'Ar L�F9- Building Division TomPerry, Building Commissioner 200 Main Street Hyannis,MA 02601 www.town,barnstable.ma.us Office: 508-862-4038 Fax• 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder IDS ,as Owner of the subject property hereby authorize +aS uor t-c-r �-rtLS Ste- to act on my behalf, in all matters relative to work authorized by this building pert application for: c2 ( Y&y Ca4tT� l (Address o Job) iguatti. or er D to Pent Name - y Q:FORIAS:OWNCE PEERNISSION btl w1 S Custo 11 BuildingCO. C Massachusetts 026321069 -� �03gzi (cell) 508-737-5400 $iu�lder:com n --?-. ' S f N RA�` r s.ngGHt _ - 3 �n Mien,cyf 1.1 W rnv '. _ Ya.. 3F:'k t3`.j': DOUCLAS L '� } 222 PtiTIB ST,= aCeuteevilteA& 02"632 � _ SUL- 03/0712014 � n v - Q !�#Q '► 4L7f s - Iiy�'' -..;. r'7 a. �'x #$ . -w MIN �� K'SSitE . 7Ft �OEttW# t - � Asti owtf d Toruntei �s F x jjt � �� 1 ##DtE tSPECTt#t� - - ..xsslx -., V - ,Q:QIi'�a5 .L �!t ,y�{�. 3.w�' i .1-" i�`� -y'¢ L L i�j`CJ GO 3�'' sy. gz } x�,� �C." -'2-" -..' -3 f .� yy '-•�`T'.9. 3 "•HJfL { _ ag x a C€AtTfRt!LL E a p. License re or€N iid foriadi idol use:ooh ., Office.o onsumer`X Taff Bue<= u'$ ire erira€�on date. if found.return.to: - HOMEMPROVEMEN'f ONTi :GTfl p# e of Consa�er A#faiirs:and:Buseness.itegulation Regisbabon 40222T f 1U ParkP#aza-Surte 5170 'Expiration 711120'14 . Boston,k A,¢21.i6 DOC�LAS L wjW� lUfSGi fSTt3iUt BUiLDlivu DOUGLAS WIU TAMS 222,PINEST. CENTERVILLE,M 02832 ` Undersecrttsry Not valld�whhout slpature J �, x V lti + ��'+.y `Mk x `= Y G ➢ l�} .. 'ym■ge e �tu'd} ,z-` ..n*:y,$kwtn al , . 3 �r �, . STAB pp IE � N ; ®• TOWN BARN RUTIOV ti: e F esitial;and Commercial8uelder ,, kx .',:i l '€g j �7 ��� Etl T�ION SPECIALISP* �_ 1 �O _ ^. QUA h R , 1 Y W-471 DIVI i March 15, 2014 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main Street Hyannis, MA 02601 RE: Insulation Permits Dear Mr. Perry, This affidavit is to certify that all work completed for permit application#201305735;Status A;Parcel 186013 at 215 Bay Lane, Centerville, MA; Permit Type RADD and issued on 12:00:00 AM has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets or exceed Federal and State requirements Sincerely, Michael McCarthy McCarthy Construction TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel K Application 6 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board (� Historic OKH _ Preservation/ Hyannis �/�--- Project Street Address h Village Owner Address Telephone 7775-2131 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!N Grandfathered: J.Yes ❑ No If yes, attach supporting documentation. cta Dwelling;T�Ipe:-Single Family Two Family ❑ Multi-Family (# units) Age of E&tinc fStructuce Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basemen yp(g:v Full 8O Crawl ❑Walkout, ❑ Other o Basemeg.FiniXed Area{sq".ft.) Basement Unfinished Area (sq.ft) Number Bad: Full: Ming 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 0 Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number NM c s o Address Bob 52 License # Cell (508) 90-6964 Home Improvement Contractor# CSL=58633 HIC-I69393 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �... SIGNATURE DATE 40, FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE f. :�w OWNER DATE OF INSPECTION: °` rt Ffq FRAME ��."..- ��.,..- r-"'r- . . t -_INSULATION,_ b FIREPLACE y. IR ELECTRICAL: , .ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL �? FINAL BUILDING-,,. DATE CLOSED OUT ASSOCIATION PLAN NO. s The Commonwealth of Massachusetts Department of IndustrialAccidents _l Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information WMEti M Curoi{ y cQastrnctl`ion Please Print Legibly Name(Business/Organization/Individual): B4T7�i 52 W"t. . 670 eIX11 , Address: Cell (NWY-2g0-6964 _ CSL-58633 - 6 City/State/Zip: Phone#: , Are you an employer?Check the appropriate box: Type of project(required): L❑A;Iam a employer with 4. I am a general contractor and I loyees(full and/or part-time).* have hired the sub-contractors 6. El New construction 2. a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance Comp. insurance.: required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑,I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Ro 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. 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 thew workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: i�cy Lam, 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D or . ce coverage verification. I do hereby certify r e p and aloes of perjury that the information provided above is true and correct. Si mature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other t Contact Person: Phone#: 1 Information and Instructions " Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant-to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as."an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,assdciafiandi olerlegals ,employing employees. However the owner of a dwelling house having not more tha-wf&ree'•a Sts and who resides therein,or the occupant of the - dwelling house of another who employs pe sobg't4�'do,i e-.ugcakr,,og$truction or repair work on such dwelling house or on the grounds or building appurtenant&rtitolslWl ifO434 4ipR,4such employment be deemed to be an employer." a � r� 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 cant'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 MASWE Revised 4-24-07 Fax#617-727-7749 www.mass_gov/dia OWNER AUTHORIZATION FORM A(C vks (Owner's Name) owner of the property located at (Property Address) (Property Address)- hereby authorize (Subcontractor) `J an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a,building permit and to perform work on my property. yOwner's Signature AR 5 13 Date C;� Q Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration �. Registration: 169393 Type: Individual Expiration: 6/16/2015 Tr# 238121 t j* ��� e � 1,i'•� ' MICHAEL MCCARTHY + �W y f MICHAEL MCCARTHY T x J i . P.O. BOX 52LL f — WEST DENNIS, MA 02670 —rn Update Address and return card.Mark reason for change. Address 0 Renewal Employment Lost Card SCA 1 ep 20M-05/11 �1e�pa�wr�aoouaea,�G/o�Ca�ac/ccaeCGi License or registration valid for individul use only Office of Consumer Affairs&Busibess Regulation g Y OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: _169393 Type: Office of Consumer Affairs and Business Regulation xpiration 6/16/2015 Individual 10 Park Plaza,-Suite 5170 �. Boston,MA 02116 MICHAEL MCCARTHY is , j MICHAEL MCCARTHY �; ' 6 RANGLEY LN. SOUTH DENNIS,MA 02660= 1 Undersecretary Not valid without signature Massachusetts-Department of Public Safety Board of Building Regulations ulations and Standards. _ Construction Supervisor License: CS-058633w MICHAEL J 11¢L CARTITY PO BOX 52 W DENNIS*A 0 70 ti Expiration Commissioner nAi1ni2n1d I Subdivision Plan Owner Daniel&Betlyann Kevles Property Address 215 Bay Ln city Centerville County Barnstable State MA Zip Code 02632 Client Daniel&Betlyann Kevles a 4 ! ' JIV Rk a aEis raa�.aa$a tiuti::���� � d. 's. 47+ �tY1 LLE;: 4 e3Yi7�FdYfi;3S.: 3%hR1�Y/1 .„. �Lo jaw'Q,TQ R8t.15tYA t a 7ent�t:i lair •431 Aaa ?# c.�flrt�ukav R+k»i .vas+9r�, "It CdFtD6D ,aa�, Mnva, t Form MAP.LOC—°WinTOTAL°appraisal software by a la mode,inc.—1-800-ALAMODE TOWN OF BARNSTABLE BUILDING'PERMIT APPLICATION . Map Parcel G�/.� � Permit# Health Division t- Date Issued Conservation Division Fee �. :. Tax Collector ENNA A A 19 ig 7 ia_ 1 �_ , '//I r Treasurer , ) Planning Dept. ; Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address �7- J 5 13,4 Village a Owner. �ti/GsL �P 4°l�� Address Y pro C4, Telephone Permit Request v 0 Sse ,`61 f7/-r�9 5�O%'/7� 60,E Jar. dcJf��� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 3 5"y g >^ Historic House: ❑Yes > Wr�o ` On Old King's Highway: ❑Yes O1�o Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other asement 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 A ' Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes O No Detached garage:❑l/existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:2rexisting ❑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 BUILDER INFORMATION Name l�j/�i �� �,�r���ti Telephone Number Address Ae-AZ /z A- License# 00 t 917-r— Z�K4 �i�; 14.1� a zl0 Home Improvement Contractor# 0 9 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE l 0e • rwq • ' S'. . 1• .. FOR OFFICIAL USE ONLY ? PkRMIT-NO. DATE ISSUED } MAP/PARCEL NO. ADDRESS 'VILLAGE < OWNER DATE OF INSPECTION1. r FOUNDATION 3 - FRAME INSULATION FIREPLACE - - - i ELECTRICAL: ROUGH FINAL 44 PLUMBING: ROUGH FINAL GAS: - ROUGH FINAL - FINAL BUILDING � a -, V DATE CLOSED OUT ASSOCIATION PLAN NO. r The Town of Barnstable • sAMsrABU& • Department of Health Safety and Environmental Services ArEo N►o�'' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 t Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to, such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: .57-tzl 4 �� Af 0r Estimated Cost to%UD 0 U Address of Work: ,4iv Lam, r,, 7Gr7ez.-, G� Owner's Name: Date of Application: I hereby certify that: T Registration is not required for the following reason(s): Fi Work excluded by law FiJob Under$1,000 Building not owner-occupied Owner pulling own permit Notice.is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. Date Owner's Name q:forms:Affidav _:=''` - — The Commonwealth of Massachusetts -- `- Department of Industrial Accidents Office oflmesfiff8dens 600 Washington Sheet s� Boston,Mass. 02111 WorkersIC om ensation Insurance Affidavit name: ;� / A—'�, (.�V/ -ff�� location: 0�o L�'Q — ci r S )le��,, hone# 7f 0'C/�41l ❑ 1 am a h6meowner performing all work myself. . ❑ I am a sole netor and have no one worldz in capacity achy %///��////////�% %%%%%/%%%%%%%%%%%%%%%%%%/O///��///�/%%//////////////////////////////%///////%%%%%%%%%��/%%%%/�%%%%////%%////%%%//l I am an employer providing workers' compensation for my employees working on this job. :..:»>'. e. lj CO .DanY::naitie.:A. n,'.;:: ::.. .:. { 7�. ..... ........ .� .. 'C��.. . .. 1. �:�':': �" > ': ��:<::::::>:>';:>;>:<>:::t;:;:: ::?:::<::`:.:.:::>::::>::::>::.:>::::>::::::::'::..... >?2:::::::::.::::i sr:::::>::>:>::>:>::«:.`:::::::>::::::: :::::::::::::.::::::�::::<::::::>_:'c:> ;:.: .:::.......::..:.::::.::...:..:.::::.;.::.;.::..::..::.:..::.:...::.::::...:.:. .::: ...::::::;;:<: ci �.4.�.. I: .:; ".;phone#.: ::: f 1 . ... :r.:; . .....;.. ansurance:ca: ::. ....... ........ _ . _ olkw# Zc1k'::;;;:..: .:.a' :: :: ::::..-..::..,:: _ ..... // ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have . thefollowing workers'..compensation polices::.:::::. .:::::::::::::::::.:::.::::::::::::.::::::::::..:::::.::.::::::,::.::,::::::::::::::::::::::...:::::::::::.::.:......::.:::::.::::.::;.:;.;:.;:.::::. ... ..... coi>:oanv name ::.::..:;.: :<::: a ..,........................... :.:;:.r:;:.>r:::.;:.;:;:.:;.;:.;:.;:.:.::.r;:;::.:;;:...-.1::. :.;;.:.;;:::.;:.<;:.;:.- .::::;:.;<:;:.;:.>;>::::,>�;;:.:;.»::>:<:;:.;:;<.::<.»;;r:.»>::i,:::>::»::»:<:>:.;:;;;:.;:<;.::.>::>::»>:<:>::»:.;;:.;>::»:<:>:e:»»;:::»>:::>:. .......................................:.........::.::.::::.....:::::.:..:................:.....................:::::::.::.`..:•` :::::---'-* ::::::::::::::::::::.::.::::::::.:::::•:::::::•:.:......Y3....<..:................. ni•:: fj:f:::i::::i:::::;%;:;:j;::<{::,:i::i;Y:Li:ii:ii:ti>{::t;;;:,:'y,•:�';:�i:�:?ti•'.ii}:;%:;:;:it n�iiii}$::iii ii:::i::i :::ii:::i::::::ti:::;:i::::.:: iiiii:'::i+}:::ti::::::::::%:vi;:;:;?:':j::+'<:ii.::rill::':'."..i:i::::'::.:::'•':.'>::v::ii.:'-::....-:::::...":'''i':ii:::<>:::::::•':+5::::...........:.....::Sv::r.. 1. . 1111me ::..L.,,.......::::::.:::::.::::::::::: .. .........::::::.:::::. ..... ......................%............................................:...::.:::::. ::..................:..:...... a. .. ................. ............. ........:................................................. ::.:.�.::.�::::. ........ .....:........:..:::....:::::.:....................:............v:.::::. :,.::::•.::..................::::::::::::•::: :::::::::::::::::::::::::.::.:::...........::::::::•:::.::.:: 611tV .. ................ 11 CmnIDSRV`11mme::..:,.ir:.....::: rq::;:j:;;::;::::v:'.:;'t`.::..,.;:.,.,:::.;:::;;;:;..:. .._... . .. ��� %;:''<: Bd/lreSS: . :.:::::DIldtl t lty' t ;:':;::.;::::::::.;•::...;.;:::.;;:•:::.::........:.........:...............:::....................................... ::;i:>::::;•>:i>:.:,:;:•>::::::•::::»:•:•}:;;•:::•::::-r::•r:<•r-----:,:;•>::•>:<•:•>:»:::;>: a:,;r::;;:•>::>:•:>:.:>::: ::<;:>::.r:: :::5::3:::::i;::%:::�::�:: ::::::::::::::::::::::::::::::::: ::i::::::::::5:%::: :;::::::::::;::::::::::;;:;.;:.;...::•:.:.A y:::::::: .................................... ................................::::. .. ., .r:�v: . % ..............:...:... .......:::.::::::..:.::.- :::::..:..:...............................:....::::::::.::.::::.,•:::::::..:...............:.::::::.: :::::.:::.�:::::::.:::::._::::::r.:.::::::.�:.:::::::::.::::;... :.:.>..:::.�::::::.::::..........::> nynrancc:ca;::.:... ;:. ;':,;;':.:...:. ... ..:.:. oll ..# pl: 1. . .,..... �/ Fafime to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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 certify under the pains and penalties of perjury that the information provided above is trap and coned ". Signaturee 4�—� Date �/r/C) _ _ Print name C 6d UT G-.v Phone# 7 0'4�`O�'/1 official use only do not write in this area to be completed by city or town official ; city or town: permitAfcense# ❑Bufiding Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office . ❑Health Department contact person: phone#; - ❑Other tinned 9/95 PIA) I 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. �j 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 contacting authority. - Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, 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 peraiit/license number which will be used as a reference number. The affidavits may be returned io the Department bymail 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 @Mee of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 711e eanvrnanu eat aaaacl uaelld . BOARD OF BUILDING REGULATIONS License:,CONSTRUCTION SUPERVISOR Number CS _ 009975 Expiies 08/t3/2001 Tr.no: 4334 ---- Restricted To: 00 BILLY E CAUTHEN s _ r 86 BETH LN HYANNIS, MA 02601 _ Administrator t r � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map` Parcel DO Permit# �`� 4 Health Division060 [t9k103 P2� Date Issued _ Conservation Division �Ft 7 3 Application Fee .� ' Tax Collector 04 /�� 7-dam Permit Fee ,� 111. 7 Treasurer m r S :.:a9 B UST IM bad C CAN LIA X.0 . Planning Dept. W T 11 TZLE ` Date Definitive Plan Approved by Planning Board COM AK �T�wr REG UU a ��cc Tim's Historic-OKH Preservation/Hyannis Project Street Address Z I S 9AY LANE Village C L=w kyI I Lr Owner DAP 4 -kN A O 4y k—S Address 37 LIA)CO6✓ P. ���, Telephone 9.03 7 7 P- 3 5c C 6S/I M OV 15 of � d Permit Request Z -eri 1 Rr e. l S A K; I �C./Y1elJ �a S �-V6n O a Nt-W d4--_-_— CfJ'WnrIrYLtoP5 . . F, V 1:N Su L A'Tit oYJ Square feet: 1 st floor: existing proposed w L 2nd floor: existing proposed a�C Total new Zoning District Flood Plain Groundwater Overlay / Project Valuation 4t 45 000 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 4© W-S. Historic House: ❑Yes NNo On Old King's Highway: ❑Yes ')WNo Basement Type: ❑Full Crawl Cl Walkout 0 Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) _ Number of Baths: Full: existing 2 new Half: existing new_ Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new_ First Floor Room Count Heat Type and Fuel: .. Gas ❑Oil XElectric ❑Other Central Air: ❑Yes ANo Fireplaces: Existing 1 New Existing wood/coa stove: ❑Yes �.a No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑-new size Attached garage:,�kexisting ❑new size Shed:❑existing ❑new size Other:,`' Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ - Commercial ❑Yes ❑No If yes,site plan review# /, Current Use StV q* 'PAW) Proposed Use SIN - -& BUILDER INFORMATION Name SrC 10cN 1 LV E)Z OA JAO Telephone Number 50,? 776 0765'9 Address y7 W I Tzof 000 RD License# 0 "77a7q S • YA F.M O V6 m A 01fo&4t Home Improvement Contractor# I3/ 415 Worker's Compensation# SAI C 3 ZD— 4/0--as ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 13f:71: Co"itA IWex SerVICeS SIGNATURE DATE �� 7 tO3 FOR OFFICIAL USE ONLY 1 # PERMIT NO. t DATE ISSUED ' MAP/PARCEV NO. ADDRESS -" I VILLAGE • OWNER ' _ •_ DATE OF INSPECTION: FOUNDATION FRAME INSULATION CU L} FIREPLACE ELECTRICAL: ROUGH FINAL / j PLUMBING: ROUGH. FINAL GAS: ROUGH� ' FINAL r FINAL BUILDINGIZ�S[A`( - DATE CLOSED OUT a ASSOCIATION PLAN NO. .! - 8 33-0 1 1. 6115�� p ►. W 11 1 16 1 24" 30" 84 -11 -21 16 s , l � 1 W W301$! W213 123 6L 6L c o J� B21 BW NI (� U J RO 24.DISHVV B rJN m ¢ N —'��- TSR 18 N _ MI -w mco :E co JIco H M -11 W�I L m N °- - �I M NI 0 r N N . . + . s ... . .._ s ti In l.t.1). P N p a - o o l bir z 11££ ; ti f0 �i z -V M 116E /1££ a _ 1 ,1 96 _� } li '-- G 9 GN Aij;GS CASE i�T �J{ I I I I I I I I I I I .I I � .� I I � ' I I I I I k T,- CN - I . . t I - t I ; l i • ,_ I ! _ . _.; � 1 1 j .i.. 1- 1- j - j l � i- I r- - � j -I T ' - I AY I ! I 1 { I i -� I � i I I I1dFR.5�1.1 0 �rrJIG $�TILI'6 _ �N�N .�1� _ d _.�O x,l 9! I � I ; L- .I gy-Iv1� ! ?i' W►�t.. !6- rZX - - I IIP�OpoSE , ,...k tTGll 'i I KE V. LE S REMO DEL � � I � I Nfl�•�-w.nY 215. RAY. LANE C1n1rsV2V 1 LL C.. 7g grit App=ffz J Tahia d5.1-lb(eoattazted) th Fam0 P•uelz greseriptiYe Paehugea for dca sad Twa-Fsmiti'Residential Saildiags gutted tri r •Hcating/Cooling NiAXfMUIId FJalt Floor Hssc�a.�s Stab y Egvipmcnt Mick? Muing Glaring Cniling W P Arcs VI-) U-value? R-value R.vaiue4 R-value! R i &vsluar P83e 5701 to 6300 Resting Degrre Dar' Nonnai 13 19 10 6 Q 12Y■ 0.40 38 14 t9 t0 6 ' Normal 12'/6 0.52 30 6 15 AF LIE g 12'/4 0.50 31 t3 19 BOA N/A Normal T 15'l. 036 3a 13 6 Normal I5'J. g44 38 19 19 t0 NIAMN U 13 25 N/A Y 15'fi 38 6 15% 2 30 l9 t9 IO NIA 13 23 19% 2 3s N/Ay 18/. Z 38 19 25 NIA 6Z 18'/. 2 3s 13 19 t06 AA 18'J. 0 30 19 19 10 -� W 1.At= I, ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZIl`TG: 4• a/a GLAZING AREA(#3 DNIDED BY#2): 5, SELECT PACKAGE(Q--AA see chart above): /�� �e�- ens l eY ru►�1 P�_^�� 8,,Y 01V I-r Skyli �. h +I ►, I�e2v inn+ �G ENERGY REQ NOTE: MMENTS OTHER MORE INVOLVED M) THODS OF DETE ARE AVAILABLE. ASK US FOR THIS INFORMATION, BUIDING INSPECTOR APPROVAL: N0: Ll YES: , q-forms-0 80303 a 780 CMR Appendix J Footnotes to Table J4.2.Ib: ' lass doors, skylights, and I Glazing area is the ratio of the area of the glazing assemblies (including sliding-g basement windows if located in walls that o lazing areaoned ce,but excluding rnay be excluded fromue doors) to the gross wall the U-value requirement. area, expressed as a percentage. Up to 1/ of the total g For example,3 ftz of decorative glass maybe excluded from a building design with 300 fl of glazing area. z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table 11.5,3a. U-values are for whole units: center-of-glass U-values cannot be used. The ceiUng•R-values do not assume a raised or oversized fi'uss construction. If the insulation achieves the full insulation,thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 4 Wall R.-Values represent the sum-of the wall cavity insulation plus insulating sheathing(if used). Do not include exterior siding, structural sheathing,and interior drywall.For example, an R 19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R 6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. a The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garage5).Floors over outside air must meet the ceiling requirements. 'The entire opaque portion of any individual basement wall with an average depth less than 5d arselow of cgrade must meoned at the same R-value requirement as above-grade walls. Windows and sliding glass Basement doors must meet the door U-value requirement basements must be included with the other glazing. described in Note b. The R-vafue requirements are for unheated slabs.Add an additional R-2 for heated slabs. If the building utilizes elgbtric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. For Heatirig Degree Day requirements of the closest city or town see Table 152.Ia NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R•values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table 11.5.3b.If a door contains glass and an aggregate,U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0,35). c)If a ceiling,wall,floor,basement wall,slab-edge, 9f the area-weighted avrawl space wall mponent erage R-value is greater than or equal es.two or more areas tth o different lrisulation levels,the component P or door tom onents comply if the area-weighted average U- the R-value requirement for that component. Glazing P value of all windows or doors is less than or equal to the U-value requirement(0,35 for doors), RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.06 Alterations/Renovations $25.00 �5 Building Permit Amendment $25.00 73,6 /i FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq. foot= }_ _,,_, x.0031="— plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE [o b square feefx$64/sq. foot= Jo x.0031= 3�. plus frombelow(if applicable) GARAGES(attached&detached) square feet x$32/sq..ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq. foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) ; Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) A Permit Fee projcost 05/,01/1995 19:23 2037765700 KEVLES PAGE 01 Got 28 '03 07:56p STEVEM SILVERMHM 508 394 9618 P.2 Town of Barnstable I ALI Regulatory Services n6 F.GaGer,Director' ]BUU b g b1YISLon . Tom perry, Building Cm=Weuer 200 Main ftaeL Hye=is,MA 02601 office: 308-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A► Builder . as"Owna of the subject pcope_V hereby authorize STOOL SI Lllc I,MA ' ..to-act on my behalf, in aD mattes relation to WC&SU&onzed-bf this building.pe nit-sPPiicatiom for- 215 SAY LAVE, C 7V7rA1/ c L1r (A,ddtm at job) i�/ayl a3 5*020ue of 06= Date kr L lti� VS giant NLme Q:Polttas_owh'IIRF�ssmc� .. �\ •_�,_�__ The Commonwealth of Massachusetts Department of Industrial Accidents office onflyesali ions 600 Washington Street Boston,Mass. 02111 WorkersI Com ensation Insurance davit name: Iocation: 'Al9 city - _ Phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole //rietor and have no one worlds 'a, ca achy %/%%%%%%%%%%��%%%%%////%/G%//%%%%%/%/%%%//////%%%%%%%%//%%�////�%%%//G%///,. 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A Fafhnre to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of nafaninal penalties of a fine np to 51,500.00 mdtor one years'bnprisomnent as well as civil penalties in the foim of a STOP WORK ORDER and a fine of$100.00 a day against me: I understand that a copy of this statement may be fornarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under Ih,g pains and penalties!I=ate providedabove is trtu and carted tSl$IIStUIe a.. - Pont named �� �j L J�Y� Phone# 5-0 �7 6D�8 official we only do not write in this area to be completed by city or town official city or town: peradttlicense# ❑Buildin►g Departmeni ❑Licensing Board ❑checkifimmedlate response is required ❑Selecbnen's Office ❑Health Department contactperson• phone#; _ ❑Other ocvued 9r95 PJa7 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. E 1 s g enti An employer is defined as an individual,partnership, association, corporation or other legal ty, or any two or more 66 the legal representatives of a deceased employer, or the receiver or and including g p P the foregoing engaged in a joint enterprise, g 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. 5 also states that eve state or local licensing agency shall withhold the issuance or'renewal MGL chapter 152 section 2 r5' of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has produced acceptable evidence of compliance with the insurance coverage required. Additionally,neitherthe not rod p P 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. r PP A licants r; , please fill in the workers compensation affidavit completely,by checking the box that applies to your situation and supplying company names,*address and phone numbers along with a certificate of insurance as all affidavits may. be Accidents for confirmation of insurance coverage. Also be sure to sign and sdbmitted to the Department of Industrial y 3_ 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 numbe r 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 which will be used as a reference num_tier. The affidavits may be retnmedto be sure to fill in the permrt/Imcense number w . 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 Investlgatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or.375 . ti ` r Regulations Standards Board of Building R� TOR HOME IMPROVEMENT CONTRAC Reg�gtretion: 1,31"5 (ration: 10113f 200'i Type:':indwidual EN AILVER ` gj1�El S1i�VR °`N ��„ x' g qr 217 WTCN, .......... x T1. j BOARD OF BUILDING REGULATIONS` q License CONSTRUCTION SUPERVISOR t1 € , Number CS' 077279 X i f Expires O6/21/2004 Tr.no: 77279 Restricted To: :�00 i STEVEN A SILVERMAIV r 27 VHITCHWOOD ROAD "' 1 SO YARMOUTH, AAA 02664 Administrator �oF ,E,, Town of Barnstable Regulatory Services snxr�sxaatE. Thomas F.Geiler,Director 16 9. 9�A MA3 �`� ' lF Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT' HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, -improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements.Type of Work: k f_rclAsEl JZENOV A 110fj Estimated Cost 10, QOo Address of Work: 2.1--S BAY LA t CENTg-11 V 6 L L e- Owner's Name: UPS Sv L lTyAtip . KE W LES Date of Application:l I I !03 I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 []Building not owner-occupied . []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTYFUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: It .1 03 Sn� SI,LVERMAh) 0-7_74`79 CS Date Contractor Name Registration No. OR Date Owner's Name