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Home My WebLink About1413 BUMPS RIVER ROAD z; w 4 /J��/ t 13 um, ��lve� �V- Y a, .. ... _ _ n. k�` �� ii y�, � � _ .. Q �. � � - .. - ii �p THE Tp� Town of Barnstable *Permit `� ' ° 4751 Expires 6 months from issue date Regulatory Services Fee * BARNSTABLE, + -��- 9c� 1 ;. Lei Thomas F. Geiler,Director A,ED �A Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstab le.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number,,20_8 06 G( Property Address 1 s [Residential Value of Work 1, Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ), ;} c �.1' 1�1. �`U L,h Contractor's Name Telephone Number_ 5�0 a `7-7 5-- Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) Lr`J fl� f-ff DIWorkman's Compensation Insurance . -P ES tS PER Check one: PERMIT l� ❑. I am a sole proprietor P _ A 9n i ❑ lam the Homeowner ❑ I have Worker's Compensation Insurance . TOWN OF gAR�STAQf_� Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box)g. Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) /1 ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *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: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc .Revised 070110 4. The Commonwealth of Massachusetts Department of Industriad Accidents be , Office of Investigations . 600 Washington Street . Boston,AM 02111 < www maser ov/difa Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Auulicant Information Please Print Lezibly Name(Business/Organization/Individual). ,, I ` t- L r c+ t 3 tri3 9, •r -.�/y.l'fi Address; Ci /Stateffip: '�� -� t 1�-' 014, Phone 4- `5 08'" T7 S /tea�'`• Are you an employer?Check the appropriate bog: Type of project(required): 1.Egi am a employer4. I am a general contractor and I _ with - b. New construction employees(full and/or part-time) have hired the sub-contractors. listed on the attached sheet. 7-0 Remodeling 2. I am a sole proprietor or partner- 4 These sub-contractors have 9. Demolition ship and have no�employees employees and have wo�cers' �working aril'capacity. fi 9. ❑Building addition [No workers'comp.insurance comp.insurance. :z ��] 5. We area cotporation and its l0.❑Electrical repairs or additions 3.❑ I am a homeowner doing all worm officers have exercised their 11.0 Plumbing repairs or additions ` myself. [No workers'comp. right of exemption per MGL 121]Roof repairs insurance required.]fi c. 152,§1(4),and we have no w employees.[No workers' 13:0Other ' comp.insurance required.] . *.Any applicant that checks box#,I must also fill out the section below showing their workers'compensation policy information. fi Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the ems and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'emwensadon insurunae for my employees. Below is the poluy and job site information. r Insurance Company Name: AT PIA -- Policv#or Self-ins.Lic.#: II_�1 iP1r & I q 3 1`'V h/Z 01 f Expiration Date: / Job SiteAddress:, %w Ii 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 -,f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for imstuance coverage verificatiolL I do hereby ceriif under thepains andpe= ies of perjury that the information provided abov is true and correcx Si ^� _ - w Date: r t Phone#: Official use only. Do not write in this area,to be colleted by city or town'of)ktd City or.Town: Yermit(License# Isming Authority(circle one): 1.Board of Health 2.Building Department 3.Cityffown CkA 4.Ekcfiical inspector 5.PhtmWg Inmpedor 6.Wier l� r'�:�g�8 P'��.f2€i: • P3'rirzrt~'r.'- - `i _ Office of Consumer P_ffairS&Bdsiness Regulation v OW :HOME IMPROVEMENT CONTRACTOR — Type- .— Registration: 102227 Expiration: 7t1/2012 DBA, 'Tfns tard,�tcrncswfedgeo ti��st ��ui�tg cnmPCeft�i a � _ ' LOtfGLAS! WILLiAW1S GUSTOM 13UIL.DING 3t)hoar Occupa6oFai SatsP eaiih raituctg Courses u► _ Dougi2s r.t3!Far.?5 222?t#�fE ST. - iU-ER�JIE,MA 02632 Undersecretary F miner name Orr�ortype} = v {CcTursa-erad dam} _ Deense or registration valid for in di use onl3' before the expiration date.`If found return to: -- Office of Consumer Affairs and Business Regulation `IIi�t i L g€ z } ?s $aY=' IO park Plaza-Suite 5170, Ht a. _E.€i2 4 1�€ e t ; . Boston;llA 02116' MA "got valid without signature. t ..- SF;s�-+sfax�s-a.Abxi�hxciuc�::per. J:afr.�T.�'9 ,•x - '� I3ulttic ..- - i�t <<tt#!Ya�ttl,-I3el��crtmcttt +Pl� �afict� 134►ttd of Buildiar. R rti#tt:PPtj, rric! mantis rd, >_Pcense: CS� 169$1 Restricted to: 00 P DOUGLAS L WILLIAMS SR EBOX I M, NTERVILLE, MA 32632 s_xoiration: 3RIM12 Tr=: 193M CERTIFICATE OF LIABILITY INSURANCE 6/27/2`�" 011 TE IS ISSUED AS A MATTER OF INFOR m'noN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS ,.FlCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY ANIEFID, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES W. TItI1S CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the po)icy(fes)must be endorsed. N SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may mgtdm an endorsemonL A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). - PRODUCER -.. _.. a-, - -. �N NAE�Kathy Silvia. The Fair Insurance Agency Inc. Nr Ft (508)775-3131 (508)790-2677 619 Main Street EaNA1L fa;r..i„9@capec od.net. ADDRESS- P.O. Boa 430 ty ®r°-QOQ3194 Centerville MA. 02632 —_ ENSUR ERM AFFORDING COVERAGE ! NAIC# INSURED INSURERA AID 26158 West Barnstable Brick Co Inc DBA , INSURER 8 } Doug 'Willi— Custom Building 89PIRERC- 222 Pine Street INSURER D: ' . — Centerville VIA 02632 RNSDLTeeF_ -- — --- COVERAGES CERTIFICATE NUMgER;well-12 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MOW PERTAIN.THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES-LIMITS MOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR-T T-POtiC'1 EPF i POLICY EXP t LTR? TYPE OFIRSURANCE POLICY NUMBER R I 6VD ! D I LIMITS GENERAL LIABNTY } I EACH OCCURRENCE )s- COMMERCIAL GENEIV&LIABRITY I j i I i !pR�S(Ea mare(= FS _ L— CLAIMSMADE 0 OCCURA�AED i7(PIAIy r>r>e ) IS - •{ ' ( ?PERSONAL 8 ADV KIURY ?$ ,GIWERALAGGREGATE S I GENT-AGGREGGAT�EUMBAPPLIE{S?ER 1S 1 PRODUCTS-COMPAPAGG`S �i POLICY 1 iT i LOC } i i 1 S I AUTOMOSR.ELIABILITY I. L COMBINED SBHaE U1rR I�ANY AUTO ( a I (Ee ecMen!} I )`BODILY Rimy(Pet persar) Is ALL OWED AItIOS BODLLYUNAIRY(PEC8CGtl�nt)i 3 } 1 SCHEDLA J_D AUTOS PROPERTY DAMAGE ST v i-- 13 HIREDAUTOS } i ,- (P- _f [ ;NON-OMEDA 90S UMBRELLA L1A8 1 OCCUR ( j EACH OCCURRENCE is I—j EXCESS LIAR 3 }C4AYtiES-0tADEI. j � I J .. f AGGREGATE I$ .. OEDUCTTmE --- -F--- -- ; I j F - L m € _ - RtErERrrroN s A (�EMPLOYERS'UAAB�RJT l 1 j } TRY LjASLIITs t ANY PROPRIETORhrARTNt3tlE>CECUFiVE YJN j i EL EACH ACCIDENT D0,00D iOFFICERRAEMBER EXCLUDED? a 1 N I A j L E I DISEASE-EA EMP[AY 3 100,00 O I(MandaiapinNH) ! 1 �rWC614354012011 �d/8J2011 j44/8/2012 urAler ESSCCRIPTION OF OPERA710NS bebw ' I R [EL DISEASE-POL=UM[T i s 500,000 DESCRWnON OF OPERATIONS I LOCATIONSI VSUCLES(Anwh ACORD IOI AddB1oml RemaMs ScheduK tf more space is requited) i 4 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE VALL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, M 02601 AUTriORt�DLtRR>rSEnITATIVE a , Kathy S"Via/FAIKSI G`co-+, -r1�d•., ACORD 25(20091091 a 4qw2m ACORD CoRPORAnON. AN rights reserved. INS025(zm9o9) The ACORD name and logo are registered marks of ACORD fHE Town of.Barnstable Regulatory Services KAM 8, Thomas F. Geiler,Director ` 1639. 106, Building:Division Tom Perry,Building Commissioner ' 200 Main Street,Hy a' s,MA 02601 Www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Corriplete and Sign This Section . If Using'A Builder , as Owner of the subject property , hereby authorize to act on ray behalf, in all matters relative to work authorized by this building permit. (Address"of Job) **Pool fences',and alarms are the responsibility of the applicant. ,Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. I r- a Signature of Owner Signature of Applicant AV tfj Print Name Print Name' Date Q:FORMS:OWNERPEF MISSIONFOOLS THE T Town of Barnstable Regulatory Services B"NSTABLE, : Thomas F.Geiler,Director MASS. 1639.l •�� Building Division rFD Mp` A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a period two-year iod shall y p not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official;that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt-from the provisions of this section(Section 109.1.1 Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly / when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. . To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt Date: Jan. 20, 2010 To: Building File From R. Anderson, ZEO , Barnstable Inspectional Response Team �. Re: Hair Salon in Residence 1413 Bumps River Rd, Centerville Tenant: Shirley Clapp January 15, 2010 BOH forwarded a complaint submitted by Brian Dudley(508-771-6047) of the Hyannis DEP office regarding an alleged hair salon operating from the aforementioned residential property. Jan. 20, 2010 Responded to complaint with Cynthia Martin , BOH and FPO Martin MacNeely, COM FD. Tenant, Shirley Clapp answered rear door wearing a smock and rubber gloves. She admitted she was currently doing the hair of a visiting friend but denied that she was operating a business out of the home. Ms. Clapp indicated-that she.works at a salon in Mashpee. She stated she occasionally does hair for friends at home but does not charge a fee. She allowed me to peek into the ' kitchen. I saw only a typical kitchen, no unusual stock of supplies or professional equipment. Ms. Clapp asked who called in the complaint. I advised that the caller was anonymous but we are still bound to investigate. She immediately advised that she has a stalker who has recently been arrested. He was identified as a former co-worker named Leonard Holtzman. Ms. Clapp stated she is positive that this complaint stems from him and she intends to report this invasion of privacy to the police. I noted that the stalking episode has no bearing on our investigation and is irrelevant to this inspection. I also advised that I have no knowledge of the original source of the complaint. I explained that we are required to respond. I also advised her that if we receive another call we would be duty bound to - return. I left my business card with her and we departed. Later, Ms. Clapp called my office to apologize for her reaction. We discussed her stalker situation and the BIRST team's investigation process. I advised her that if I had to return to the house that I would leave my card in the door so she would know that I had been there. 1 ' t \ T r� is actingasgeneralcontractor/bui er for project) e submitted (except for in-ground pools) submitted. Copy of Insurance Compliance miffed (residential only). esidential only if applicable) ermission. receipt of application number ❑ Permit fee. , 1 compliance. Placement of proposed structure must d.. The location of the septic system should also be g cross section and framing schedule. Specialist's License unless the homeowner is building permit) ation of pool and the distance from property lines. e. ications. iaterials used. r f TOWN OF BARNSTABLE s BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE k JOB LOCATION f Number Street"Address Section, Of Town "HOMEOWNER" Vl! tll(14-t1( lJl Name. Home Phone Work Phone PRESENT MAILING ADDRESS So City/,Town : State Zip Code Thecurrent exemption for "homeowners" was extended to include owner- occupied- dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the{owner acts as supervisor. d DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which ch hp/she sh e resid es s or intends to reside, on which there is,. or is intended to be` ' a one to six family dwelling, attached or detached structures accessory.to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109. 1. 1) The ,undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, -laws, rules and regulations. The 'undersigned "homeowner"- certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL ' N .ote• Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. 3, MZSCS � :• - . 5. • 3 HOME OWNER'S EXEMPTION The code states that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption, are unaware that they are assuming the ,,responsibilities of a supervisor (see Appendix Q, Rules and Regulations for '-Licensing Construction Supervisors, Section 2 . 15) . This lack of awareness often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the unlicensed person as it would with licensed supervisor. The Home Owner acting as super-visor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, many communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities On the last a P of a supervisor. e of this issue page is a form curr ently used by several towns. You may care to amend and adopt such a form/certification for use in your community. s i 4 ' v Assessor's office(1st Floor): `� Assessors map and lot num o? 0 �' 4 d � � o�THE TO Conservation Board of Health(3rd floor): Z aaassrant Sewage Permit number L/K 2 Cpwe iA y /qA rya Engineering Department(3rd floor): /��3� o 39 House number '' Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSP CTOR APPLICATION FOR PERMIT TO O2 L3 f`C�C9 L 7(�O TYPE OF CONSTRUCTION 1-aANLIZ- 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies.for a permit according to the following information: , L-( I/ Location 4(� V/`-'p 5 P-i Proposed Use �� h(�L t= l=/� Jam+`f L- ?°� (�l/ri Ir�--�1`c G Zoning District /� o Fire District L'i�itl r- �JS l"— i�� i� 4!;M1 Name of Owner V1 l/f f`f N4v`t— Address &b 5 C r t2 e t' i Name of Builder Address Name of Architect Address Number of Rooms Foundation Exterior s ® Roofing A-5 P/4AL-'r- Floors Interior k/oox7 Heating W �- S Plumbing Fireplace Approximate Cost 4 :�?cq/ t9 C9 f) Area ld Wit fI,,;- � Diagram of Lot and Building with Dimensions Fee � 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 Construction Supervisor's License NAULT, VIVIAN F. l No Permit For 34970 REMODEL INTERIOR - ` Single Family Dwelling - _ F' _ Location 1413 ` Bumps River Road M„Centerville Owner = Vivian F. Nault Type of'Construction' Frame Cr Si Plot r t "Lot i .4� s i c f Permit Granted . Apr i 1"14 , 19 ?9 2 Date of Inspection 19 Date Completed ®,/� _19 �' Sq r.