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Barnstable
�.enx"tMNt"tr weaR.& ". WPohseterdw�aUnC„t eirlt Fifinicaa.�lt aen os.pfeO}tccticiou..,..n�,a'H��a cs Bti I.,s`,e;eRne M.>ualr�G=.e�d s�s u';c�h Bwldom B sh.. ........ aallr,,; no•Mt,bsuest tO abc'ec buR eilteaedi nuBuilding
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uild in
Must be.Ke os s
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Permit
de
n.
Permit NO. B-18-1209 Applicant Name: Carl Rebello Approvals
Date Issued: 04/26/2018 Current Use: Structure
Permit Type: Building-Insulation-Residential Expiration Date: 10/26/2018 Foundation:
Location: 120 FULLER ROAD,CENTERVILLE Map/Lot. 189 124 Zoning District: RD-1 Sheathing:
Owner on Record: WYND,NANCY � C�ntrac ,Name CarlJ Rebello Framing: 1
Contractor License GS 084358
Address: JOHNSON &WYMAN FAMILY TRUST 2
CENTERVILLE, MA 02632 Est Protect Cost: $1,779.00 Chimney:
Description: Air Sealing& Door weatherstripping. � � ��� � �Perm�t F�Pe: $85.00
Insulation:
106
,,.
Project Review Req: Femme Paid F $85.00
�DateF 4/26/2018 Final:
Plumbing/Gas
OR
v Rough Plumbing:
_.._.
Building Official
-Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work a thoeized 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.
All construction,alterations and changes of use of any building and structures shall be in with the local zoning by laws,and codes.
Final Gas:
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for publi-Ins n for the entire duration of the
work until the completion of the same. Electrical
` r
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
Service:
Minimum of Five Call Inspections Required for All Construction Work � Rough:
x
1.Foundation or Footing �. g
= - �_.
2.Sheathing Inspection Final:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Roughs
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 -
I
t
2"x 8"Header 2"x 12"Header
WINDOWS AND DOORS
1- Andersen FWG6068 W/L
1- Andersen CN235
1- Brosco 2898 Steel LH458
2"x 12"Header
O o ;
DW---
Closet
SCALE 1/4"+ 1"
WILLIAMS PROJECT - 120 FULLER ROAD,CENTERVILLE, MA.
THE HOUSE COMPANY 1/31/95
1
,
2"x 8"Header 2"x 12"Header
WINDOWS AND DOORS
1- Andersen FWG6068 W/L
1- Andersen CN235
1- Brosco 2898 Steel LH458
L
i
2"x 12"Header
• o
DW
Qo
Closet
F1
SCALE 1/4"+ 1"
WILLIAMS PROJECT - 120 FULLER ROAD,CENTERMILLE, MA
THE HOUSE COMPANY 1/31/95
i
- 3o7 l Sin Suc:,iiy w>»N.f+402601
Offia: 548-?94-6227 g�ph
Fa�c 508?75 3344
BEa(EMg C=missiona
For crff cc use only
Permit no.
Date
AFMAVIT
HOMEIMPRO`'EMENMONI ACP RL&W
SUPPIXITTO PERI41TAPPUCATION
MGL c 342A rrquurs chat thc'Scaovnstrz><tioq altaatiar�rrnotatiou„ �, :;
imps remmaL demolition,or oortsauctiou of an addition to air pre-aasdag owacr occapied
building conanining at Icast one but not morn than four darning units or to strucw=which am adFac=
to such zrsidcncx or building be done by rrgistcte;l contactors,with ocriain exceptions,along with other
zrgturrmcnts.
T•`peofuJork: kitchen remodel Eg.Cog $10,000
AddressofWork: 120 Fuller Road, Centerville, MA
p"-n<�rNlanx: Nancy Y. Williams
,/Date of Permii.Application:
I hcrrbt catifvthat:
Rcgistr2uon is not rquircd for the follouin€rc2son(s):
Wort:<xcludd by 12w
Job under S 1000
Ecilding not oR-ncr-occvpicd
O%,ncr pulling own pazrtit
2,otice is hcrcbv Si\cn th2t:
OtiO.�ETIS PULU NG T.�)R O��';:i fr�'�i O" DSA.iTN6 v-, Tr'UNREGISTERED CO�"TRACfORS
FOR APPLICABLE FOME P..CF=ON T:•E1`i '."OT 1: DO 1110T KAVE- ACCESS TO Ti-r
A�i TTR�T10�FROG=�t;OF CiJf �'•�"FL�r�L��fF.?•;Ci c 1«A,
SIG'�1=D Li7;DLRPLI;A.LT1E�01-PLFIL'.
q� J; f Goldstein 100932
OR
Datc O�ncr's nam,c
0001
11/02,194 17:02 V6177277122 DEPT IND ACCID
Corn4nozuuealt{z, of Maj4acfzu�ettd
' �aParfinerc�o�.�'•ndudtria.l✓'Vccedenfl
600 1/Vaa�&-Shin t
James J.Campbell &ton, //laaach. tb 02 f f i
Commissioner
Workers' Compensation Insurance Affidavit
], Jeffrey Goldstein (The House Company)
(pCensecJpermtaee)
with a principal place of business at:
60 Benjamin Franklin Way, Hyannis Maccarhu.SPtts 026,03
(city/suPizfv)
do hereby certify under the pains and penalties of perjury, that:
I am an employer providing workers' compensation coverage for my employees working on
this job.
Fidelity & Casualty Co. 28C 815 1118 94EV
Insurance Company Policy ?lumber
() I am a sole proprietor and have no one working for me in any capacity.
() I am a sole proprietor, general contractor or homeowner (circle one) and have hired the
contractors listed below who have the following workers' compensation policies:
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
Contractor insurance Company/Policy Number
() I am a homeowner performing all the work myself.
!understand th--t a copy of dais s:ztement will be forwarded to the Office of invesdrzdons of the DIA for coverage verificaiion and that failure to secure
ccverage as rewired under Sccdon 25A of MGL 152 can lead to the Imposition of criminal penalties comisdne of a fine of up to S 1,500.00 andler cr,e
yeas' imprisonmem as well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me.
day of February r 19 95
Signed this Y
Lic e/ a ittee Building Department
Licensing Board
Selectmens Office
Health Department
TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375
TOWN OF BARNSTABLE BUILDING PERMIT
F1w -ec V"
HOME IMPROVEMENT CONTRACTORS REGISTRATION
:° oard of Building Regulations and Standards.
One Ashburton Place — Room 1301
Boston , Massachusetts 02108
HOME IMPROVEMENT CONTRACTOR
Registration 100932 Expiration 06/24/96
Type — PRIVATE CORPORATION
HOME IMPROVEMENT CONTRACTOR
Registration 100932
OHC Inc . DBA/ The House Company Type - PRIVATE CORPORATION
Jeffrey Goldstein Expiration 06/24/96
6.0 Ben Franklin Way i
Hyannis MA 02601 UHC Inc. DBA/ The House COmp,:
Jeffrey Goldstein
jG� o 7� f!7 en Franklin way
ADMINISTRATOR Hyannis MA 02601
I
Failure to possess aCurrent
COMMONWEALTH DEPARTMENT OF PUBLCc:SAFETY Ali,iseekessitaWate8ritding
(l
OF.. ONE ASHBORTOM PLACE odeJs cause ro n for
MASSACHUSETTS BOSTON,MA 02108 LICENSE CAUTION
EXPIRATION DATE CONSTR. SUPERVISOR
EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST
03 1 1 8/19 96
n �QQ THEFT, PUT RIGHT THUMB
RESTRICTIONS PRINT IN APPROPRIATE
NONE 08/31 /1993 042406 R BOX ON LICENSE.
g JEFFREY GOLDSTEIN
16 COVE LN POBX 474 g BLASTING OPERATORS.A 02637
M m l UDE HO�o
r7_
PHOTO PLASTWG OPR ONLY) FE`1o0.00
NOT VALID UNTIL SIG BY LICENSEE AND OFFICIALLY AUG 2 7 1993
HEIGHT: STAMPED•OR-SL TURF OF THE COMMISSIONER
1/
THIS DOCUMENT MUST BE « SIGN NA�N4L ABO -SIGN0URE 54
ORE OF LICENSEE
CARRIEDON THE PERSON OF 51 T
THE HOLDER WHEN EN-
OTHERS•RIGHT THUMB PRINT GAGED W THI$OCCUPATION. ER
APk-
NOTICE NOTICE
TO > TO
EMPLOYEES EMPLOYEES
r
The Commonwealth of Massachusetts
DEPARTMENT OF INDUSTRIAL ACCIDENTS
600 Washington Street, Boston, Massachusetts 02111
617-727-4900
As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice
that I (we) have provided for payment to our injured employees under the above mentioned chapter by in-
suring with:
THE -FIDELITY-AND-CASUALTY- COMPANY
---------------------- -------- --- -------- ---------------------------------
NAME OF INSURANCE COMPANY
P . 0 . BOX 3332 GLENS FALL , NEW YORK 12801-7332
ADDRESS OF INSURANCE COMPANY
-----2�� _l l A .......................................May_31_1994------
POLICY NUMBER EFFECTIVE DATES
DOWLING AND O ' NEIL INSURANCE AGENCY , INC . 508-775-1620
------------------------------------------------- ----------------------------
NAME OF INSURANCE AGENT ADDRESS 2 2 2 West Main Street PRONE
Hyannis , MA 02601
-------'iU_ -0-u-A�LY-------P�_4 _B4N_II45b--- Barnstable L MA __02630----------
EMPLOYER ADDRESS
- ----------------------------------------------------------------------------
EMPLOYER'S WORKERS COMPENSATION OFFICER (IF MM DATE
MEDICAL TREATMENT
The above named insurer is required in cases of personal injuries arising out of and in the course of
employment to*furnish adequate and reasonable hospital and medical services in accordance with the
provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured
employee. The employee may select his or her own physician. The reasonable cost of the services provided by
the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to
the work related injury. ui cases requiring hospital attention, employees are hereby notified that the insurer
has arranged for such attention at the
_ Cape Cod Hospital --------------------- 27- Park Street , Hyannis , MA 02601
--------------- --------------
NAME OF IK)SPirAL ADDS
TO BE POSTED BY EMPLOYER
LIAB 460E Printed in U.S.A.
�Asscssor's Office Ist floor Ma v Permit#
'a 'CConservation Office 4th floor dD 901 2 Z Date Issued „- Q_5
Board of Health 3rd floor
Engineering Dept. Ord floor) House# �1 d
Planning Dept. (1st floor/School Admin.Bldg.): i
NAM ..
Definitive Plan Approved by Planning Board.' 19 'b�a
(Applications processed 8:30-9:30 a.m.&1:00-2:00 p.m.) IhST'A SEPTIC S AILED IN M(IST'BE
MP
- �® LIAP,lCI;
' 'MI TITLE 5
TOWN OF BARNSTABLE
Building Permit Application
Project Street Address 120 Fuller Road
Village Centerville Fire District C-0-MM
Owner Nancy Y. Williams Address 120 Fuller Road, Centerville, MA
Telephone (508 ) 775-0462 �,/
Permit Reguest: Mt9 ye t&/ 6��/01,l0 + 6_tlor
Zoning District Flood Plain Water Protection
Lot Size . 22 acre Grandfathered
Zoning Board of Appeals Authorization Recorded
Current Use sincle family resid11 Proposed Use same
Construction Tyne wood frame
Eaistimt Information
Dwelling Type: Ingle F Two family Multi-family
Age of structure 25 years +/- Basement type full concrete basement
Historic House N a Finished
Old Kings Highway N/A Unfinished__
Number of Baths -2- No. of Bedrooms -3-
Total Room Count(not including baths) 5 rooms First Floor
Heat Type and Fuel FHA hg n i i Central Air N/A Fireplaces Yes-1
Garage: Detached Other Detached Structures: Pool
Attached Barn
None Sheds
Other
Builder Information
The House Company
Name Jeffrey Goldstein Telephone number (508) 771-0303
Address 60 Benjamin Franklin Way License# Lic.Const. Sup. #042406
Hyannis, MA 02601 Home Improvement Contractor# 10 0 9 3 2
Worker's Compensation # 2 8 C 815 1118 9 4 E
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
Barnstable landfill
Project Cost $10 ,0 0 0
Fee t'52-0L
I SIGNA DATE Feb. 2 . 1 99 5
BUILDING PERMIT DE ' D FOR THE FOLLOWING REASON(S)
1 BPERM T
Si C) FOR OFFICE USE ONLY
,''f _ 2/3/95 +
189. 124
ADDRESS 120 Fuller Road VILLAGE Centerville
_ _ t
OWNER Nancy Williams ;
DATE OF INSPECTION:
FOUNDATION
FRAME /r:X � -
INSULATION 1�
r
F
FIREPLACE '
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING:
r
DATE CLOSED OUT:
ASSOCIATE PLAN NO. . s
r -
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Z