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0113 HAYES ROAD
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'�4 " ` 3 ) OHOUSE;,PC mailing PXi.Box i-82 Mashpee,MA.02649 �1 office: 18,,steeple Street Mashpee Commons 1 � Mashpee,MA 02649` structural design phone:: 508-221-2980 & ingenuity emgd, iensen0inahousemet, we.,. www.lhdhouse.net` October 9`h,2019 ING 19092 David Kerr(General Contractor) 364 Old Oyster Road Cotuit, MA RE: Structural Review of the New Structural Ridge Beam's Post Support atop an Existing Clay Brick Chimney,located at an Existing Residence at: 113�Hayes Road,_Center_ville,-MA Dear Mr. Kerr: INGHOUSE has performed a general visual review of the structural post support atop the existing clay brick masonry chimney at the project residence on Tuesday, October 8th, 2019. It is our understanding that the existing chimney, which does not extent through the roof surface any more, will be abandoned in its function as a wood burning fire place. A new gas insert has been installed inside the former fire box, and the unit will be vented via metal flue pipe. Therefore,'the typical building code stipulated framing clearances for wood materials, or the use of non-combustible members at masonry chimneys is not required any longer. The existing masonry chimney is in adequate structural condition to support the additional loads from the new structural ridge member being posted on its perimeter walls at the attic level. We have discussed on site that (2)-2X6 build up post studs shall be added to the already installed (4)-2X4 build up post, which currently supports the,new L VL ridge beam. ,The new (2)-2X6 post shall bear, atop the brick wythe located directly adjacent to the interior side of the wythe currently used for support of the (4)-2X4 built- up post. The new(2)-2X6 post plies shall be connected via. 6" long Timberlok screws(by Fastenmaster), or equal wood screws at 8"on center, staggered, along the full post height. Upon completion of the above described post INGHOUSE finds the constructed use of the new post support for the structural ridge beam atop the existing, remaining, clay brick masonry-chimney structurally adequate.` Please do not hesitate to contact us with any questions. iN OF qqq - Very truly yours, �� LARSJENSEN /Jg� _ o STRUCTURAL INGHOUSE " -No:50602 y Lars Jensen,P.E., S.E. q�Q`ST Enclosure: Photo Documentation 0/ y/2011 i add (2)-2X6 built- up post, see letter specification /001� t �e a . INGHOUSE 10/09/2019 113 Hayes Road,Centerville,MA-post atop existing chimney support Page 1 of 1 f W Carter, Jeff From: INGHOUSE <Jensen@inghouse.net> Sent: Monday, May 11, 2020 12:25 PM To: Carter, Jeff Cc: dskerr3@comcast.net- Subject: David Kerr project at 113.Hayes Road, Centerville, MA Attachments: INGHOUSE_letter-Ryes Rd structural_signed.pdf Good Morning Mr. Carter, I am writing in regards to a project, located atl 13 Hayes Road, Centerville, which the general contractor, David Kerr, is trying to close out. We had originally provided the general contractor with a sealed letter, which outlined the findings of our site visit and proposed structural solution. The letter had been sealed electronically. (Please see attached copy for reference.) It is our understanding, that you would like to receive a "wet stamped" copy of the original structural design letter. ,1 . Due to the current Corona virus situation, we are trying to submit our deliverables electronically, in order to minimize risk for all parties involved, as well as save time for all parties. Please let me know, if we can find a way to avoid having to submit a "wet stamped"hard copy of the structural letter for this project. Thank you, Lars Jensen Lars 3ensw P.F,,S, A �5�(1JtSl:�Yd1Yd�.a�l — il'1ghouse, I3C mailings PA Box 182 Mashpee,MA tit o0fte: 18 stile Street structural dmsignr Maaslwee Comnm=5' 4 ingenuity, phone: 5 -221-29 entail. kw minr1a&e.= web. =letfJit send a d,., x� r rat,t a�Q,.. s : o h; vamr a,!f-nu-,61 ilm th,.,�xa,mraa,zaa2 ,ryFrr�zrnrrF ,,zs� Virus-free. www.avast.com CAUTIONThis email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and.,know,the content`is safe! i Town of Barnstable Building �rA PostfThis Card So That it is Visible From the Street, .Approved Plans Must be Retained on lob andRthis Card Must be Kept0AW I Posted Until Final Has Been Made. ° er It #� Wh,pre a Certificate of Occupancy is Required;such Building shall Not be Occupied until a Final Inspection has been made. Permit NO. B-19-426 Applicant Name: DAVID KERR Approvals Date Issued: 02/25/2019 Current Use: Structure Permit Type: Building-Addition/Alteration- Residential Expiration Date: 08/25/2019 Foundation: Location: 113 HAYES ROAD,CENTERVILLE Map/Lot210-094 Zoning District: RD-1 Sheathing: Owner on Record: DAUBERT,AMY F TR Contractor Name: DAVID F KERR Framing: 1 liL. Address: 1119 HILLCREST CIRCLE i e Contractor License: CS=045395 2 CHAPEL HILL, NC 27514 V Est. Project Cost: $61,000.00 Chimney: Description: demo existing kitchen and build new kitchen at rear of house. build Permit"Fee: $361.10 new bathroom at old kitchen location. interior modifications of Insulation: p �� (cZ q Fee Paid. $361.10 selected walls. upgrade and or add smoke detectors . Final: i Date 2/25/2019 Project Review Req: SMOKE DETECTOR UPGRADE REQUIRED:CbDETECffR=1 A REQUIRED TO BE WITHIN TEN.FEET OPBEDROOM DOORS, � � 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. All work authorized by this permit shall conform to the approved application and the�approved 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 zoning by-laws and codes. f ' ' ection for the entire duration of the Final Gas: This permit shall be displayed in a location clearly visible from access streetor road and shall be maintained open o ,r.public ins p work until the completion of the same. i r° .. « "' Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the-Building and Fire Officials are provided on this;permit. Minimum of Five Call Inspections Required for All Construction Work:!- '. Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection - •:•-r 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.lnspection 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). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT OF . C OBUILDING D EPT: Application Number.... s� F EB 08 2019 Purr Fee........ .. .���..1.�:�. ....other Fee.......................... Total Fee Paid............ .. ................ .. TOWN OF BARNSTABLE Permit Approval by... .....:. ...` ..........on. ...... BUILDING PERMIT . I..C:...................PaC..........al . APPLICATION Fi+�►au. sT - $ectimi l Owner's Information and Project.Location Project Address %13 l�E% zyk Village C. i2y lz4z ' w Owners Name 4 i'l Y t>40 fit.� Owners Legal Address 111 1 1 6 UG2Z�►' City. c.N6o PAL IVI.L State ,tA C, _ Zip Z 75 14— Owners Cell# SAS-�74? &4 E-mail Section 2—=Use of Stractare . Use Grroup ❑ Commercial Structure over 35,000 cubic feet =` ❑ Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3--!'I`ype of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Stricture ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement El.Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler.System ❑ Addition ❑ Retaining wall ❑ Solar Renovation ❑ Pool ❑ Insulation Other—Specify Section 4�Work-Description -, 7� T'► �' Gil 3 cT c. ,c.�Te,l.�?� AT iZTA YZ LocAmor.A &Lgl, Z T act Tmdated:2M/201 S j r Application Number.................................................... i Section 5—Detail Cost of Proposed Construction Square Footage of Project' Age of Structure Dig Safe Number # Of Bedrooms Existing 3 Total#Of Bedrooms(proposed) 3 110 MPH wind Zone Compliance Method MA Checklist,❑ wFCM Checklist ❑ Design t _ Section 6—Project Specifics A wince ' ❑ Qil Tank Storage ' �f ��Smoke Detectors Plumbing ❑ Gas ❑'Fire Suppression ❑ Heating System ❑ Masonry Chimney Add/relocate bedroom A Water Supply Public - — ------- -- Sewage Disposal unicipal On Site Historic District ❑ Hyannis Historic District ❑• Old Kings Highway Debris Disposal Facility: RAq+%-rA6i,% I am using a crane ❑ YesO No Section 7—Flood Zone _ Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes 0 No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. , Total Frontage Percentage of Lot Coverage " #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard,, .Required Proposed Side Yard Required , Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last tmdatM-219/2019 • ✓/fie �cv�v�za�u�erz�l�a�✓�a�aa�'��1�: Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR_ Registration valid for individual use only i 9 TYPE:Individual before the expiration date. If found return to: Reaistiation Expiration Office of Consumer Affairs and Business Regulation 13ti833_ 12/02/2020 1000 Washington Street-Suite 710 Boston,MA 1 DAVID KERR DAVID F.KERR U 364 OLD OYSTER RD,- idiot Val d Without Signature COTUIT,MA 02635 - Undersecretary; Construction Supervisor Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic Jneters)of enclosed - space. Failure to possess a current edition of the Massachusetts S is cause for revoc State Building Code ation of this license. For information about this license Call(617)727-3200 or visit www.mass.govldpl i Commonwealth of Massachusetts j.�t Division of Professional L_icensure Board of Building Regulations and Standards Construd ri Supervisor CS-045395 �7 +* E4 ires: 11/17/2020 , r DAVID F KERR 364 OLD OYSTER RD `l: COTUIT MA 02635 Commissioner cj— r , The Commonwealth of Massachusetts• . Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.govMa Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/tndMdual): V.)A\� IV, Y.1M R1L Address: 3 to 4- City/State/Zip: Cdi MA Q26 3 y� Phone#: rj off'- 7�'Z- Z 6 37 Are you an employer?Check the appropriate bow Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I * have hired the sub-contractors 6. ❑New construction employees(fall and/or part-time). 2. ] I am a sole proprietor or partner- listed on the attached sheet` 7. X Remodeling 1 ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an c employees and have workers' Y aPY• 9. El Building addition [No workers'.comp.insurance ` comp.in�+�nce.� - required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions �N myself o workers' com . right of exemption per MGL y p '12.❑Roofrepairs insurance required.]t c.152,§1(4),and we have no 13.❑Other. j — —empl0yee5.[NO-workers' — 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 contactors must submit a new affidavit indicating such. .Contractors that check this box must attached an additional sheet showing the name of the sub-contactors and state vyhether or not those entities have employees. If the sub-coatactors have employees,they must provide their workers'camp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: } Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: ChY/St wzip: 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance verage verification. I do hereby certi under penalties of perjury that the information provided above is true and correct± Si atme: • w Date: I • Phone#: Official use only. Do@not write in this area,to be completed by city or town ofjYcial City or Town: Permit/License# Issuing Authority(circle one). 1.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.PIumbing Inspector.- ,' 6:Other Contact Person• Phone#: '_ Tbwh pf Barnstable Building Department:Service Q , _ msrAracE, * Arian Florence,.C$O y, MASS, �Uildin g. Commissioner ene'� 200 M�aiii Street,kI�°annis;.NtA U260I - �v�.to�sc.barost�ble.mma.aes , Of>=ice: 508-862-40.33. Fay:' 508-']9E?-G230 ^ Complete air Si&m This' 'Secdo If A � > � I, ✓!'� / : La 4,(,�J ,as Owner of the:subject jvr)pert hereby authorize:_DA 0 t kv e to act.on my behalf, p in all rn�ttc rs;r.1afi re to work aurhori7e. ley this builclin�}�trm t application for: (As reSs gfJob) "Nol fences and alarms are the fill onsibility of the a flolicant: Pools, Zre not to be llc- •br util* 0 before fence; is installed and aiI final g :i'rispc'ettons arcezfc�rned and acre tet�: Suture of Owi er Si�ma 'ire l plicanr V e i� Print:game hrint Niame l Date. Q:FOR.XIS OWNI RPf',RNl1SSIONPOOI S ltevi 08.`16?I.7. FApplication Number............................................ Section 9—.Construction Supervisor Name P A v 3> ),Sk-k- Telephone Number Address3&4- ag> c L,cs9 zit 20, City.Q cs v,7- State _V7A Zip License Number C_1�7 0 53__31 "License Type b .� Expiration Date 2' Contractors Email 1�e('f ,�P, CoM , Ctfl�- Cell# 5 IZA -73? -Z(o 3? I understand my responsibilities under the rules apd regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts derstand the construction inspection procedures,specific inspections and documentation required 80 own of Barnstable.Attach a copy of your license. Signature Date r 6 Section-10-Home Improvement Contractor Name DA�� i 7 -�7.a 9- Telephone Number • �a� = ?3? - 2��'� - - -- -- -- Address 3(0 4 oc P o,ts►`kQ,2V City c i;o �r State .M)` 3 S Registration Number r 3 833 Expiration Date i'ZI.p zo i I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 ` CMR the Massachusetts State B ode3T . 7Bamstable. the construction inspection procedures,specific inspections and documentation required by 7 Attach a copy of your EUC... Signature Date 1 Section 11—Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number r> I understand my responsibilities under the rules and regulations for Licensed Constriction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.' a Signature Date t - - T SIGNATURE) Signature Date i Print Name D,Q,,i 1 ;D )<jCgL Telephone Number E-mail permit to: dskerr Ai' O'c T em. n mnni o i Section 12 —Department Sign-Offs" Health Department © Zoning Board(if required) ❑ 11 stork District ❑ Site Plan Review(if required) ❑ Fire Department _ ❑ _ - j Conservation For commercial work,please take your plans directly to the fire department for approvd- ' I Section 13—Owner's Authorization as Owner of the-subject property hereby authorize to act on my behalf in all matters relative to work authorized by this building permit application for: (Address of job) ' Signature'of Owner y _ Print Name '• . r _i Last uadated:2/92018 t 2 Fuller St. Carver,MA 02330 mcmahoninsulation@gmail.com' 781-831-1234, Date:February 20,2019 Permit#:B-18-3 0 66 Address:113 Hayes Rd.Centerville Attn:Building Inspector Jeffrey Lauzon for the Town of Barnstable, We installed the following insulation/completed the following work at 113 Hayes Rd. Centerville; Ma.02632. r Including: • Walls: dense pack cellulose to fill wall cavities via "drill-and-fill" methods This work has been completed to stretch energy codes applicable at the time of installation.The walls have been scanned for voids (missing insulation) with IR scans by our own crews. This work is utility funded and audited, and is held to the highest standards of workmanship and quality.All work has been completed in compliance with State Building Code 780 CMR. - Please don't hesitate to contact us with any questions! Respectfully, Michael T. McMahon Owner 781-831-1234 Z.� /9 ®. . 2 Fuller St., b • Carver, MA 02330 mcmahoninsulation@gmail.com 781-831-1234 Date:February 20,2019 Permit#:B-18-3606 Address:113 Hayes Rd.Centerville Attn:Building Inspector Jeffrey Lauzon for the Town of Barnstable, I We installed the following insulation/completed the following work at 113 Hayes Rd.Centerville,` Ma.02632. Including: • Walls: dense pack cellulose to fill wall cavities via "drill-and-fill" methods This work has been completed to stretch energy codes applicable at the time of installation.The walls have been scanned for voids (missing insulation) with IR scans by our own crews. . This work is utility funded and audited, and is held to the highest standards of workmanship and quality. All work has been completed in compliance with State Building Code 780 CMR. Please don't hesitate to contact us with any questions! Respectfully, Michael T. McMahon Owner 781-831-1234 Town of Barnstable ' • �. .�- ,�� Building Post This Card So�That„rt•is Visible Fr„om-the Street,-A rovetlPlans Must be:Reta�ned:on Job�andth�seCard M„wstube Kept �„ ;�. �M Posted Until.Final ans ection�Has Bee IVlatle pp 4 . . ° .Where aCertificate'of.Occu anc" s Re u�red�° uch�Buildm Fshall�Notm,be.O.ccu led°.until a�Final Ins action has.been made Permit .....�: _.. .�.�.,; ; ..-..... ;� .�� �. any: , ...Q ,. F:;� �....,•, g�...-;, .�. z.. . .,:. � . s� �, ,,�:. �.. :� a��. -..�. �::.... ... .. Permit No. B-18-3606 Applicant Name: Michael McMahon Approvals Date Issued: 11/01/2018 Current Use: Structure Permit Type: Building-Insulation Residential Expiration Date: 05/01/2019 Foundation: Location: 113 HAYES ROAD,CENTERVILLE Map/Lot 210 094 Zoning District: RD-1 Sheathing: Owner on Record: Amy Daubert x�E Contractor'Name' ., Framing: 1 Y 31 Address: 1119 HILLCREST CIRCLE Contractor,License 2 k „Est Project Cost: $8,828.00 • At cl CHAPEL HILL,NC 27514 .; k J. Chimney Description: w herization weather stripping,air sealin �blown cellulose eermrt Fee: $95.02 eat pP g. g, v _ Insulation: a FaeePaid' $95.02 Project Review Req: �¥ E Date 11/1/2018 Final: v Plumbing/Gas - Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed,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 docume As- which-this permit has been granted. All construction,alterations and changes of use of any building and structu es shall be in compliance with the local zong by lawsand codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for.pubhc inspection 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 signatures�by the Building and Fire Officials are provide�on this permit.cN Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing �' Rough: 2.Sheathing Inspection 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). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map D Parcel°a ®� I� i OR r�, Permit# rMS7 BARNSTABL Health Division w� r _ �,��-3 �'n( 'Date issued r7W oa �S � Conservation Division �e 8: 33Application Fee �2/04! Ly, Tax Collector /fit/.4LC #dP)0AtS Permit Fee Treasurerpy 4W LPI l? 56tU fy`� SYZEMMUSTBE INSTALLEDCOMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE ANDTOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address I W Village ���� Owner 4 Address Telephone � I ` 1 Permit Request 12140W PkiWOAt L00 h 1 e ° AXU6 te SIIto P 3 Square feet: 1 st floor: existing proposed 2nd floor: existing -.proposed ,Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes; attach supporting documentation. Dwelling Type: Single Family O Two Family ❑ - Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes YNo On Old King's Highway: ❑Yes N No Basement Type: ❑Full Crawl ❑Walkout ❑Other Basement 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 Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove:" 'Cl Yes ❑No 41 Detached garage: ❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing. ❑new size Attached garage:❑existing ❑new size Shed: ❑existing ❑new size Other: _ 4 - Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes --❑No -- If yes;sitepian review# Current Use Proposed Use BUILDER INFORMATION Name I Telephone Number S9 Address License# Home Improvement Contractor# 02U4 Worker's Compensation# 69 4 N-772_p]RM 56S ALL CONSTRUCT 0 DEB IS RESULTING FROM THIS PROJECT WILL BETAKEN TO . �Q 4 SIGNATURE DATE 3 r 4Y FOR OFFICIAL USE ONLY t p. MRMIT NO. DATE ISSUED _ MAP/PARCEUNO. T • -:' r ADDRESS VILLAGE ' x OWNER DATE OF INSPECTION: FOUNDATION _ FRAME INSULATION' FIREPLACE - ELECTRICAL: ROUGH FINAL - PLUMBING: RO[�'---H- > i-- -FINAL :- GAS: ROLW FINAL f � r m _ , FINAL BUILDING tz _ t cr ro © ± r DATE CLOSED,OUT "S < N - jr,% .� '1 �- M C1 - ASSOCIATION PLAN NO. t ` jKe - Town of Barnstable rqf� .. Vf Regulatory Services • snxivsrnB . ' Thomas F.Geiler,Director q�p • A�O� ' Building Division TED MA'S 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. s.\ k F Type of Work: �J L Estunated Cost Address of Work: Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law ❑Job Under$1,000 OBuilding 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 here y ap ly for a permit as the agent of the o ere � M Date Co tractor Name Registration Nd. OR Date Owner's Name Q:forms:homeaffidav __ The Commonwealthof Massachusetts - Department of Industrial Accidents - — ��ce atlnyest��at�arrs • 600 Washington Street - - T Boston,Mass. 02111 Workers' Com ensa#ion Ynsnrance Affidavit e. 1 . ovation �� city all work elf ' ❑ I am a homeowner performing m3's ❑ I am a sole *et and have no one workin in ca acl a sal%e /////////%/////%///%//////////%////%%%////ation/1,l�%///%/e//////%i//%%%S/%/ on %b�////////////////////////////l////////// providing workers comperes :for °Ye >ki a, all em 1 eI �. o •: 5fi br :?•b'r ' a �,}` y•; ax^tq xw, <.'`;4 �i• w3•{ v y <i I am oY $ {. :.2Zrrt;44+•'• '9 }:•.•2. µ, ,c•< "•`,;:" ` 5•Ci' t• ri ,J{ '{':;'':''� .`.%'•,'t< r£*�,'{tk}�:• c t•• '�{•.`'StT'a4�..t.:,#,r: '"•': `�'�t•ar�^y;.£,Y�r'r!'t ks`'; :k;,•� ry •,,,�{n,$ x � ,{b,T a.'�••o...w. .n.l^:?n•��>h'r.':{k:•. 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Home Improvement Contractor License#(if applicable) 7 Otonstruction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ Jeon the Homeowner l have Worker's Compensation Insurance ww. Insurance Company Name Workman's Cotnp.Policy# G .j 0/2- Permit Request(check box) E�Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over y existing layers of roof) Re-side ❑ Replacement Windows. U-Valtie (maximum.44) ❑ Other(specify) "Where required: Issuance of this permit does not exempt compliance with other town department regulations.i.e.Historic.Conservation.etc. u4 x . 9/?e. Board of BuildingRe ula (01 g s and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 128857 Type: individual Oliver Kellyy pi ration: 08/14/2003 Oliver , y 603 Wn-St. Unit 8 Yaftouth' MA 02673 Update Address and return card.Mark reason for change KELLY ROOFING 9 PEREGRINE LANE SOUTH YARMOUTH PHONE/FAX (508) 775 4498 MA 02664 INSURED MA REG# 128957 APRIL 27 03 PROPOSAL ISSUED TO MR DICK ADAMS. WE PROPOSE TO SUPPLY ALL MATERIALS AND LABOR NECCESARY FOR THE COMPLETION OF ROOF REPLACEMENT ON HOUSE AND GARAGE AT 113 HAYES ROAD CENTERVILLE. ALL DEBRIS TO BE REMOVED TO TOWN TRANSFER ICE AND WATER DAMAGE PROTECTION MEMBRANE TO COVER FIRST THREE FEET OF EAVES AND VALLEY AREAS 8"ALUMINUM DRIP EDGE TO BE INSTALLED ON ALL EAVES. REMAINDER OF DECK TO BE COVERED WITH 430 FELT PAPER 30 YEAR ALGAE RESISTANT LIMITED WARRANTY SHINGLE TO BE INSTALLED,SIMILAR COLOR O EXISTING + RLkShiwV-65 -M W STOW" 1JA�I�f.,D, �Srx PEGi.S��rvGtG BATHROOM VENT PIPE BOOTS TO BE REPLACED WITH NEW SmAu), VeNT 1 W Rcap 6vFfk-2xwl IG Ao0tvl -'r IqT E'���K�D Ago�►�' PROTECT ALL WALLS,WINDOWS, DECKS,FURNITURE,PLANTS AND SHRUBS ETC. DURING ROOF STRIP. SECURING OF TOWN PERMIT. AT A TOTAL COST OF$4550 PAYMENT SCHEDULE 30%WITH SIGNED CONTRACT,BALANCE UPON COMPLETION. RESPECTFULLY.SUBMITTED,( OLIVER KELLY PROPOSAL ACCEPTED BY, KELLY ROOFING IS INSURED AGAINST LIABILLITY AND ALSO CARRIES WORKMANS COMP AS REQUIRED BY LAW COPIES OF WHICH ARE AVAILABLE UPON REQUEST. w%46 '/c u. 1 f,3a7r> ,E ASe CAL'. V)�' ` 01< J Ailtael k 4AWM s ;lfie t�anvrrcaiuvec�C�i a� `� g DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION.}SUPERVISOR LICENSE C. t - Number Expires: - Restricad to; 00 .��NIS,.M;..MGWICLIANS 45 CEDAR ST . W BARNSTABLE, NA 02668 HOME;IMPROVEMENT ;CONTRACTOR Registration 116599. "Y v Typex , 3INDIVIDUAI ti Expiration 0028/98 s r DENNIS M MCWILLIAMSs ENNIS M. MCWILLIAMS ' �a ADMINSTRAMR 45 CEDAR ST I;,lox 15. • `cW BARNSTABLE MA02668 \� I ng Up r Map 2)b Parcel 0 7 Pe mit# House#:� 6/�O�cf ' s ` Date Issu d oard of Health floor)(8:15 -9:30/1:00- ) r e Conservation Office th floor)(8:30-9:30/1:00 2:00). Zfe Planning Dept.(1st floor/School Admin. Bldg.) SEPT,C SR Y tME ' tNSTALLE E Definitive Plan Appro ing Board 19 - CE W TOWN OYBARNSTABLf?V°RONWE �� pnp�A /'►k' pE AND i Building Permit Application f Yd' Project Address ��3 .4165 /&Xb Village ' 7(° fi(GG(s i Owner P-1 ' 46 z_s Address 1-14 G`S �"TrOfi/i!GC -Telephone " Permit Request ' G 6G t P > i r* i -First Floor square feet Second Floor i square feet Cons ction Type i Estimated 'ect Cost $ � �� P i Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure istoric House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkou ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New ,,,No.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 w /coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name / '11,11t S /V?fl,166,4,1A117__S Telephone Number 3j!�2— 3 Address 4;1Z) iQ S j License# O6 cK 9_S S �SA6ZNS.,lI L(r Home Improvement Contractor# r / G S`� 9 Worker's Compensation# 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 SIGNATURE !ems' DATE_I12 BUII ; 1G ERMIT DE IED FO > FOLLOWING REASON(S) I, FOR OFFICIAL USE ONLY r r. PERMIT NO. DATE ISSUED. MAP/PARCEL NO. 1 - ADDRESS s VILLAGE z OWNER - 3 r DATE OF INSPECTION.. FOUNDATION, FRAME t INSULATION. FIREPLACE ELECTRICAL: ROUGH •'FINAL. , PLUMBING: t ROUGH:'- + FINAL ` r GAS: r LR( GH C) FINALin - _ t FINAL BUILDING N Q F - t _•--R....a.fn 0 • . •- - DATE CLOSED OUT ray 0tit - t ASSOCIATION PLANNd . in ai t Y_ i y .f y0 The Town of Barnstable sARMAK& i 9ebp � �0� Department of Health Safety and Environmental Services rFo " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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: ����'� �� />V -+cT Est. Cost s G Address of Work: K6 5 AW /D Owner's Name /YI< Gf�E7S Date of Permit Application: 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 GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a mit as a agent of the owner: s-9 Date Contractor Name Registration No. OR Date Owner's Name The Commonwealth of Massachusetts Department of Industrial Accidents Office of/nrestigatians ^= �^� 600 Washington Street Tr� Boston,Mass. 02111 Workers' Com,JPensation Insurance Affidavit name: 114-Wl4c/A iyti� location: 4�- ce 1D41t�-- s-r city �.iC'S�% l-A,)5 9z A, phone# 3',6 2 93 ❑ I am a homeowner peXZ rforming all work myself. I am a sole pro rietor and have no one workin in any capacity ZZ ❑ I am an employer providing workers' compensation for my employees working on this job. company name. . - address,.- ..... city. . phone#. insurance co. olcv# ❑ 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: company-name:: address. A phone#. Ynsaranee cm...... DO] CV.# company name: address. city- phone# insurance co. olic # ��. 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 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 t and penalties of perjury that the information provided above is trua and correct g --e r A �� Si tore Date Print name _� r /'���t//s,Gr Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other :...,. ,...::.. . .... ..... ........... .:.... (revised 9/95 PJA) i Information and Instructions . Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their P q __ 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 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 pi number which will be used as a reference-numb er. The affidavits may be returned io 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 Imlestlgatl01113.. 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 M CMR App m is 1 Table JS=b(continued) prescriptive Packages for One and TwaFamily Residential Buildings Heated with FOuW Fuels MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Hesting/Cooling Am'(@A) 11-value= It value' R value' . R values Wall perimeter Equipment Efficiency' pie It value° R value' $701 to 6500 Hating Degree Days' Q 121'a 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 95 AFUE T 15% 036 38 13 25 N/A N/A Normal U 15% 1 0.46 38 19 19 1 10 6 Normal V iS•/. 0.44 38 13 2S N/A WA 83 AFUE w 15% 0.52 30 19 19 10 6 85 AFUE X 18% 032 38 13 25 N/A N/A Normal Y 18•/. 0.42 38 19 25 N/A N/A Normal Z 18% 0.42 38 13 19 10 6 90 AFUE AA 18•/. 10.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-1980303a .. rrr,rur r - wa �Hi i4 9�fll •1 -�-t ak 96,". . r P R P � E . -ZAA19 ' - �;:. � r ': +w�+' 7"^ys`s -11" 3�r. ,!, SMOKE DETECTORS REVIEWED � p : Z, c 1° A N. B BUILDING T. DATE C, FIR _,EPARTMENT DATE BOTH-SiG1" T URES ARE REQUIRED FOR PERMITTING �; ; FAF 4 • _ ° - 1 r f° IQ Am 2 < ( x . s u Barnstable Bldg.DePl- d by. APpr Permit#. FI. „s .... ... mh'.. ..�':,,,77- r W..;%p21w.-�� ri ., ...ya.xr c 'ka�n i.r f.44 M'd`..77,77-: r..;1'77mwl a, f E _ ,tts" .T2*,4:3'ttvx -.�.- 'g �7r tii.?�} ..h.iti:n7.. • � ~ ' �� s� 6� b� Z� r o 21 xm7lrlf® 57E 1 EVIEYY� ..i -t�A R L B ILDI DEPT. r DATE., tt w , 1� FIRE DEPAR ENT DATE 9VAN SIGNATURES _E REQUIRED FOR PERMITTING Kl 1 f - : k • W w. �,'P3`�'k w..,�•"'�s .�,`,�R, �' wok `e. z, i.�sv�..�_,. .F �� _ � _ �'� ,. - 1 A Barnstable Bld .'Dept: i ?� Appr din: ` r. I Pernat # - ' - � � �.+.''. ak"aE� ;��«. �.v.ly,u:�.��;Fd --.=� �' ,�'�-�;'^�"'�a��,, h�'- _ ;.��:�3:.,: '- a' _ v:.. ,ussJ•": .�..y ,�, •s.w � � - m to 44 is ��CA x