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NO. 152 113 SCR 7
MADE IN USA 0 ESSEL'E
Qyo�TNETp�yTOWN OF BARNSTABLE
I EARISTLBLE,
s639.
am BUILDING INSPECTOR
APPLICATIONFOR PERMIT TO ....... . .................................................................................................................
TYPE OF CONSTRUCTION ................
... ........................ ......601, .. .......................................................
. ...........................................19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
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Location ......WA y......0 t4...... C.7,��.0 7..............C4�.ZAC-9
.. ........
Proposed Use ........ ............
7- A447...................................................................................
ZoningDistrict ........................................................................Fire District ...............................................................................
Name of Owner P.4611....../1....SA A.1.7-ale.S6.........Address
'Name of Builder .........1�.a.
.........................Address ......................................................................
Name of Architect C/,sz, ......&P. ............Address 9,4 4�.P-r.....40/7V 49
.........................
Number of Rooms ......0?1.041. .........................Foundation
Exlerior . .........Roofing ... ............................................
Floors&V/I.(14.....711_,Jg��... ......... ....Interior PL-. /
...Interiorie /....
Heating ........ .... ... .......................................Plumbing ... .....
...
Fireplace ................ .................................Approximate Cost ...........................
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Definitive Plan Approved by Planning Board -------------------------------19
Diagram of Lot and Building with Dimensions
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Nam p-_ ................................................. ........
Santorsola, Paul ZA.
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15820 �o�ne story
No ................. Permi or ....................................
single family dwelling
...............................................................................
of�g...P-1pie—Stre.e t Location ...... ................... . .....11.5H..Zft, L
.......................Cen.t.ervi.I.I.e...................................... . ........ . . ..
........Owner .....................Paul.... .A............. ....San t.orso.1a..............
Type of Construction ..................frame........................ \j
............................................................... ................
Plot ............................ Lot ................................
3
Permit Granted ...........................January 9 7.............19
Date of Inspection ....................................19
Date Completed ....... .Sig
PERMIT REFUSED
................................................................ 19
................................................................................
................................................................................
...............................................................................
...............................................................................
Approved .................................................. 19
...............................................................................
...............................................................................
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Post.This Card So That�tris Visible From the Street ApprovedPlans Must be",Retained on Jobandxth�s Gard Must be Kept
BARNSUBIi,1639.
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*� Posted Until Final'Inspection Has Been Made x
p yj'� t
� a Where a Cert�ficate,of Occupancy r Requered,such Bu�ldmg shall Not<be Occupied until a Final Inspectionhas been made x�
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Permit No. B-18-1872 Applicant Name: Mike McMahon Approvals
Date Issued: 07/06/2018 Current Use: Structure
Permit Type: Building-Insulation-Residential Expiration Date: 01/06/2019 Foundation:
Location: 34 BEE LANE,CENTERVILLE Map/Lot: 249-026 Zoning District: SPLIT Sheathing:
Owner on Record: COTTER, RICHARD E �,= Contrac to r Name MICHAEL T MCMAHON Framing: 1
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Address: 34 BEE LN Contractor License CS-068111 2
CENTERVILLE,MA 02632 Est Project Cost: $2,800.00 Chimney:
Description: Weatherization,insulation,weatherstripping,and air sealing Permit Fe„'e: $85.00
Insulation:
Fee Paid:" $85.00
Project Review Req: Final:
Date 7/6/2018
Plumbing/Gas
Rough Plumbing:
" &Building Official Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized;by this permit is commenced within six months after issuance. 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.
` Final Gas:
All construction,alterations and changes of use of any building and structures shalWe in compliance with the local zoning by laws`.and codes.
This permit shall be displayed in a location clearly visible from access street or,road and shall be maintained open for public!mspection 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 si natures b t'he Builcdm and Fme Officals are rbVidecl on this permit.
Service:
P Y PP g y� g � A w p ,
Minimum of Five Call Inspections Required for All Construction Work:' s= Rough:
1.Foundation or Footing .-� •-.
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
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Regulatory Services r» .0
'f9►aestaa F.Gaiter►Director
Bat"sg Division
Tom lrsvy, itWUlag ConwAsOnttr ��
200'.146 Sanest. HYaces,MA 02601 R
ESS PERMIT
Cfficc: SU6.56:�038
Fart: $08-790.6230 NOV 2 5 2003
f Ivor r%t,.►�ea.wer®rx-i ost�.rt.� TOWN OF BARNSTABLE
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Home lropcovcmcnt CoMutar Ure®rc is(it apphra,it)_
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Board of Building Regulations and Standards
HOME IMPS OVEM'ENT CONTRACTOR
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The Commonwealth of Massachusetts
Department of Industrial Accidents
Ofllce Of h7Yesffgz11#os
600 Washington Street
.� Boston,Mass 02111
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Workers' Compensation Insurance Affidavit
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location: 1J
sJnlSf i'!'// `f /1'l phone# -- ?7 cS' V' 60
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
I am an employer providing workers' compensation for my employees working on this job.
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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: '
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insurance co. poh
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Inlnrsnec eQ .. �gy#
Failure to secure coverage-as required under Section 25A of MCL 152 can lead to the imposition of criminal penalties of i fine up to S1,500.00 and/or
one years'Imprisonment is well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day agalast me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
1 do hereby ee under the pains an pe 1 les of perjury that the information provided above is true and eorrecL
Signature Date
Print name �P CD /ZJ®h hone# 'JEZ �'
official use only do not write in this area to be completed by city or town official
city or town: permit/license g nBuiiding Department
• � �Llccnsing Board
0 check If immediate response is required 0Selecttnea's office
C]Health Department
contact person: phone#; nOther
(reined 3/95 PIA) - ..
Information and Instructions
Massachusetts General Laws P provide chapter 152 section 25 requires all employers to workers' compensation for their
P 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.
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 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 per number which will be used as a reference number. The affidavits may be 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,Wlephcne and fax n�. 1'. .. .
The Coinni-4--.1
Department oi`%ndusi:r_::'.
tl(fiCe Of 111VUH82HOUS
600 Washington Street
Boston,Ma. 02111
fax #: (617) 727-7749
phone #: (617) 727-4900 ext. 406, 409 or 375
HOME IMPROVEMENT INSTALLATION CONTRACT
Branch Name:T Date: � �� Sold,Furnished&Installed by
The Home Depot Installed Sales
Branch Number: Job#: C��� U 345A Greenwood Street,Worcester,MA 01607
Toll Free(800)657-5182; (508)756-6686; Fax:508-756-2859
Federal ID#75-2698460 ME tic#C 02439 RI Cont.Lic#16427 CT Lic#565522
1 l MA Home Improvement Contractors Reg.#126893
Installation Address: 3 7 � Zey?e C-�//M yjlle /� 0 h �_C
City State Zip
Purchasers: Work Phone: Home Phone:
( ) ( )
Home Address:
(if different from Installation Address) City State Zip
Project Information I/We("Purchaser"),the owners of the property located at the above installation address,offer to
contract with The Home Depot("Home Depot")to furnish,deliver and arrange for the installation of all materials as described
on the attached Spec Sheet#1t/V 12�_,incorporated herein by reference and made apart hereof.
Home Depot reserves the right to cancel this contract if,upon re-inspection of the job,Home Depot determines that it
cannot perform its obligations due to a structural problem with the home or because work required to complete the job
was not included in the contract.
DEPOSIT PAYMENT OPTIONS
(Subject to fund verification and/or credit approval.)
L/f 1. Check,Cashiers Check or US Postal Service Money Order
CONTRACT AMOUNT $ (made payable to The Home Depot).
2. Credit Card*and/or other payment options-Circle One Below
-LESS DEPOSIT $
�VisaMastercard Discover American ExpressBALANCE DUE m Improvement Loan Home Depot Credit Card e
ON COMPLETION $__S�9 J P p° � U�
,Avanable C•All c- (HIL&HDCC ONL )
*25%of Contract Amount due upon execution of this : 0contract.One-third(1/3ra)of Contract Amount is required AcctAi — —. - `= x Date:
for MASSACHUSETTS RESIDENTS ONLY. Name as it appears on card:' C/ 4Z 675t /—
Indicate Payment Method For By r signatu below,I/We agree to allow The Home Depot to charge the
BALANCE DUE ON COMPLETION abo ere eA di r the a it indicated.
x�/
azdholdersSignature Date
If this is a finance transaction,the agreement for financing is contained in a separate document,which is incorporated herein by
Reference,and made a part hereof. At-Home Services Credit/Loan Application Ref.#
Purchaser agrees that,immediately upon satisfactory completion of the work,Purchaser will execute a Completion Certificate and pay any
balance due(unless the job is financed,in which case,upon submission of the executed Completion Certificate,Home Depot will be paid in
full by the lender). Purchaser also agrees to be jointly and severally obligated and liable hereunder.
For Mass.Residents Only: Contractor,at owners expense,shall procure all permits required by law as follows: Owners who
secure their own permits will be excluded from the guaranty fund provisions of MSL Chapter 142A. Unless otherwise noted
within this document,this contract shall not imply that any lien or other security interest has been placed on the residence.
Entire Agreement: This agreement and its attachments,including any financing agreement,contain the complete agreement
between the parties and can not be amended or modified unless in writing in a separate agreement signed by both parties.
NOTICE TO PURCHASER
Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep
it to protect your rights. Do not sign any Completion Certificate or agreement stating that you are satisfied with the entire project
before this project is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed
by the owner prior to the actual completion of the work to be performed under the contract.
You may cancel this transaction at any time prior to midnight of the third business day after the date of this contract. See Notice of
Cancellation for an explanation of this right. There will be a service charge equal to 25% of the contract amount if the job is
cancelled by Purchaser AFTER the third business day.
BY MY/OUR SIGNATURE BELOW,UWE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. I/WE ACKNOWLEDGE
RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION.
BY MY/OUR SIGNATURE BELOW, UWE UNDERSTAND THAT THE AGREEMENT IS SUBJECT TO REVIEW OF MY/OUR
CREDIT HISTORY AND IIWE AUTHORIZE HOME DEPOT AND RMA HOME SERVICES,INC.,A HOME DEPOT AUTHORIZED
CONTRACTOR, TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEPENDENT CREDIT REPORTING
AGENCY AND RELEASE T I FR M AALLL LIABILITY INCURRED FROM INADVERTENT OMISSIONS OR ERRORS.
SUBMITTED BYgales
C/ ✓f Date: U `�
ons t
ACCEPTED BY: Date:ne {
Date:
Homeowner
NOTICE:ADDITIONAL TERMS,CONDITIONS AND WARRANTIES ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT
White-Branch File Yellow-Customer Pink-sales Consultant
9.18-02 C-SC
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Town of Barnstable "Permit w~ 12 0_ L 'B
_ F.spises 8 ueeaflraJaotn t*aw dote
X Regulatory Services Fee Cd
td79�a�� Thoraces F.Geder,Director
Building Division
Tom Perry, BuildiNg Commissioner
Office.- 508-862-4038 200 Main Street, Hyannis,MA02601 X-PRESS PERMIT
Fax: 508-790-6230 OCT 3 2003
RESS PERM T ALPLIC - R SIDEIN'r ^Xyr Y
NotYardw ptafRedx-presar*p,N: TOWN OF BARNSTABLE
SIAP/parcel Number
PropertyAddress15-9-Ce- Rh i
Residential
// Value of Work_ f ` `�—OD__
Oaner's name&Address��r[!� 3 Ig.�
[J�P 3
Coatract.is Name M � kS�RU,,,C —\relephone Number_�_8"
Home Irnptovement Contractor License#(if applicable)
CoastrucdOn Supervisor's License#(if applicable) —
2'0�orkman'.s Compensation Insurance
C'heck one:
❑ 1 am a Sole proprietor
❑ I am the Hameowner
E- 'shave Worker's Compensation Insurance
Iusurtnue Company Name
W'orltrtran'$Comp.Policy# l�.l'� 9
Permit Request(cbeck box)
❑ Re-roof(stripping old shingles)
❑Re-roof(not stripping. Going over e..xisting layers of roof}
ate-le-side
; Iact;mont l U-V
Windows. aue ®• ,� nwirnum.
- ( 44)
❑ Other(specify)
•�vhcrc required: Issuance of this pemrit does;not exempt COMPhAncewith other town 4 epartrncnt ex$aiations,i.e.Historic,COngayst;ox,ems,
Signature _
Q:FotTne:eaptnar -
Revised!3l 9o!
po. 2
�► Town of Barnstable
Regulatory Services
Qwass Thomas F.GeUer,Director
eD ,a" Budding Division
Tom Ferry, Building Commissioner
200 Main Street, Hyannis,MA o2601
Office; 508-8624038 Fax: 508.790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
as Owner of the subject property
hereby authorize v02 to act on my behalf,
in all matte:, relative to work authorized by thia building pemait appLcation for:
(address of Job)
G114k,
g�atuae of er Date
Print Name
Q:6Y.MIS:OWNT'R.PM ISSION
The Commonwealth of Massachusetts
Department of Industrial Accidents
= on/ceo%%ist/�►auoos
600 Washington Street
Boston,Mass 02111
Workers'Compensation Insurance Affidavit
ly
namel
cil
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0 1 am a homeowner performing all work myself
1 am a sole proprietor and have no one'working in any capacity
1 am an employer,providing workers' compensation for my employees working on this job.
Al
no
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0 1 am a sole proprietor,general contractor or homeowner(circle one)and have hued the contractors listed below who have
the following workers'compensation polices: '
company name:
77- 7777771777
sidd Lis;
l:
b.
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■fine of S100.00 a day against me. 1 understand that a
copy of this statement may be forwarded to the Office of Investigations orthe DIA for cove rage.verlficalion.
I do hereby certify under the pains a p Ides of perjury that the Information provided above Is true and correct. y
SignatureGpn� We O
Print namePhone N �3 Q
official use only do not write in this area to be completed by city or town of6elal
city or town: err�nirnccnse p -
I N Building Department
h ❑Licensing
p cheek if immediate 1 Board response is required 0Selectmen's Office
❑liealtb Department
coniact person: phone tt; nOther
(rmsed 3/95 PJA) - - ,
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